title: Prompt analgesic effect of antihistaminic diphenhydramine ointment on bone-joint-muscle pain as assessed by skin impedance.
abstract: Pain is sensed, transmitted, and modified via a variety of mediators and their receptors. Histamine is a well-known mediator of pain. In addition to their antagonistic effects against histamine, classical antihistaminics possess, to various degrees, antimuscarinergic, antiserotonergic, antiadrenergic, local anesthetic, membrane-stabilizing and other pharmacologic actions. Although there have been many attempts to use classical antihistaminics as analgesics and/or analgesic adjuvants, the appearance of non-steroidal anti-inflammatory drugs discouraged such efforts. Here, we compared the analgesic effect of an ointment containing 1% diphenhydramine (a typical first-generation antihistaminic drug) with that of indomethacin (a typical non-steroidal anti-inflammatory drug) in elderly patients with osteoarthritis and/or osteoporosis who complained of bone-joint-muscle pain. Analgesic effects were evaluated by measuring skin impedance and by subjective pain assessments (using a visual recording system) before and after ointment application. Diphenhydramine ointment exerted a prompt and marked analgesic effect that lasted for several hours, as assessed by either skin impedance or subjective pain evaluation. In contrast, the analgesic effect of indomethacin ointment was marginal, and significant only an hour or more later than that of diphenhydramine. These results suggest that diphenhydramine ointment may be useful for the relief of the bone-joint-muscle pains that are common in elderly subjects.
authors.affiliation: Katsuragi Hospital, Kishiwada, Japan.
authors.forename: Takuo
authors.initials: T
authors.lastname: Fujita
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Ohue
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Fujii
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Jotoku
authors.forename: Akimitsu
authors.initials: A
authors.lastname: Miyauchi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Takagi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Endo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004155:Diphenhydramine / Q000627:therapeutic use*; D017097:Electric Impedance; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000188:drug therapy* / Q000503:physiopathology; D009824:Ointments; D010003:Osteoarthritis / Q000188:drug therapy* / Q000503:physiopathology; D010024:Osteoporosis / Q000188:drug therapy / Q000503:physiopathology; D010147:Pain Measurement; D012867:Skin / Q000503:physiopathology
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006633:Histamine Antagonists; D009824:Ointments; D004155:Diphenhydramine; D007213:Indomethacin