Pheniramine dependence in obsessive-compulsive disorder: A case report

Abstract

BACKGROUND:

Pheniramine abuse is reported not only in patients with psychiatric disorders but also in the general population.

CASE REPORT:

We report a case of pheniramine dependence in a patient with obsessive-compulsive disorder. The patient took about 250 mg orally daily and injected about 90 mg every week from the last six months. It reduced his anxiety, was cheaper than his other psychiatric medications, and free of stigma. He had lethargy, headache, uneasiness, anxiety, and poor sleep as withdrawal symptoms.

RESULTS:

This case highlights the vulnerability of those with psychiatric disorders towards pheniramine abuse. Hence, this report advocates the strict evaluation of over-the-counter drugs for patients with pre-existing psychiatric disorders.

Keywords

Antihistamine abuse dependence pheniramine obsessive-compulsive disorder

Get full access to this article

View all access options for this article.

References

Paul

Sood

Paul

Puri

. Acute renal failure caused by pheniramine maleate induced rhabdomyolysis: An unusual case. Indian J Crit Care Med Peer-Rev Off Publ Indian Soc Crit Care Med. 2009;13(4):221–3.

Buckley

Whyte

Dawson

Cruickshank

. Pheniramine—A much abused drug. Med J Aust. 1994;160(4):188–92.

Monte

Chuang

Bodmer

. Dextromethorphan, chlorphenamine and serotonin toxicity: Case report and systematic literature review. Br J Clin Pharmacol. 2010;70(6):794–8.

Balhara

YPS

Jain

Dhawan

Mehta

. Assessment of abuse liability of pheniramine among opioid-dependent human subjects. J Subst Use. 2011;16(6):484–95.

Selvaraj

, Pheniramine dependence, a case report. Paripex Ind J Res [Internet]. [cited 2020 Jul 20]. Available from: https://search.proquest.com/openview/f33310f0f5386d6fb3071109916aef54/1?pq-origsite=gscholar&cbl=237750.

Rao

Varambally

Venkatasubramanian

Gangadhar

. Hazards of antihistamine dependence in psychiatric patients: A case report. Int J Risk Saf Med. 2015;27(3):153–7.

Barnett

Taber

Roth

. Activity of antihistamines in laboratory antidepressant tests. Int J Neuropharmacol. 1969;8(1):73–9.

Pal

Kumar

Bhushan

Berry

. Psychiatric co-morbidity associated with pheniramine abuse and dependence. Indian J Psychiatry. 2005;47(1):60.

Prakash

. A case of hypochondriasis with dexamethasone and pheniramine dependence. J Subst Use. 2015;20(1):73–5.

10.

Humble

Hellbom

. Letter to the Editor. Nord J Psychiatry. 1998;52(5):440–1.

11.

Miller

. Atypical antipsychotics: Sleep, sedation, and efficacy. Prim Care Companion J Clin Psychiatry. 2004;6(suppl 2):3–7.

12.

Charlton

, Self-management of psychiatric symptoms using OTC psychopharmacology [Internet]. [cited 2020 Jul 23]. Available from: https://www.hedweb.com/bgcharlton/sdtm.html.

13.

Kavanagh

Charlwood

Peachey

. Withdrawal symptoms after discontinuation of long-acting brompheniramine maleate. Br J Dermatol. 1994;131(6):913–4.

14.

Das

Palappallil

Malathesh

Chatterjee

. Chlorpheniramine dependence presenting as mania. Asian J Psychiatry. 2017;30:29–30.

15.

Hellbom

. Chlorpheniramine, selective serotonin-reuptake inhibitors (SSRIs) and over-the-counter (OTC) treatment. Med Hypotheses. 2006;66(4):689–90.

16.

Gammoh

Mayyas

Darwish Elhajji

. Chlorpheniramine and escitalopram: Similar antidepressant and nitric oxide lowering roles in a mouse model of anxiety. Biomed Rep. 2017;6(6):675–80.

17.

Barekatain

Aminoroaia

Samimi

SMA

Rajabi

Attari

. Educational needs assessment for psychiatry residents to prevent suicide: A qualitative approach. Int J Prev Med. 2013;4(10):1200–5.