title: Comparison of the sedating effects of levocetirizine and cetirizine: a randomized, double-blind, placebo-controlled trial.
abstract: BACKGROUND
  Compared with placebo, levocetirizine has been found to be less sedating than cetirizine in separate trials. However, whether levocetirizine is less sedating than its parent drug cetirizine has not yet been studied in a randomized trial.
  
  
  OBJECTIVE
  To determine whether levocetirizine is less sedating than cetirizine.
  
  
  METHODS
  We conducted a randomized, double-blind, crossover, placebo-controlled trial examining sedation and allergy symptoms in patients with perennial allergic rhinitis who had previously reported significant sedation with cetirizine. Enrollment ran from January 28, 2009, to February 25, 2009. All patients completed the study by April 17, 2009. Thirty patients enrolled, and 29 patients completed the study (1 patient did not return her questionnaire). In a double-blind fashion, the 29 study participants received levocetirizine, 5 mg daily for 1 week, cetirizine, 10 mg daily for 1 week, and an equivalent placebo pill for 1 week in randomized order with washout periods before each treatment arm. At the end of each washout period and each treatment period, participants completed a 1-page questionnaire. This questionnaire included questions about sedation or sleepiness in the form of a modified Epworth Sleepiness Scale, a Likert scale measuring general or global sedation, and allergy symptoms as measured by the total rhinitis symptom score.
  
  
  RESULTS
  Sedation as measured by both the modified Epworth Sleepiness Scale and the Likert scale was not significantly different between the levocetirizine and cetirizine treatments.
  
  
  CONCLUSIONS
  In patients with a perceived history of sedation with cetirizine, most were able to tolerate levocetirizine. However, this controlled trial also suggests that many of these patients would tolerate cetirizine if given in a masked manner. Therefore, patients with a history of mild to moderate sedation with cetirizine are unlikely to experience a different sedation profile with levocetirizine.
authors: Allergy and Asthma Physicians of Central Kentucky, PSC, Lexington, Kentucky, USA. dtzanetos@hotmail.com
authors: Douglas B
authors: DB
authors: Tzanetos
authors: John M
authors: JM
authors: Fahrenholz
authors: Theresa
authors: T
authors: Scott
authors: Kristina
authors: K
authors: Buchholz
mesh_terms: D000328:Adult; D000368:Aged; D017332:Cetirizine / Q000008:administration & dosage* / Q000009:adverse effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000276:immunology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D039563:Histamine H1 Antagonists, Non-Sedating; C472067:levocetirizine; D017332:Cetirizine