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Have Decompensated Cirrhosis And Insomnia. Will Histamines Help?

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Posted on Fri, 12 Apr 2013
Question: My husband has cirrhosis (decompensated) with terrible insomnia. Have seen articles that histamines may help. Any thoughts or advice ñ
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Answered by Dr. Seikhoo Bishnoi (53 minutes later)
Hello
Welcome to Health Care Magic

Your husband is suffering from severe insomnia and is having decompensated hepatic cirrhosis. Management of insomnia in severe hepatic cirrhosis is really challenging.
Conventional medicines of sleep like Benzodiazepines as Clonazepam, Lorazepam or Zolpidem etc are usually avoided in severe cirrhosis because of risk to serious side effects due to poor metabolism of drugs. May lead to hepatic coma.

As you have mentioned about anti histaminic drugs, yes in a lot of studies they have found to be useful. Medicines like Hydroxyzine can be used. Hydroxyzine is a antihistaminic drug and it is used in anxiety disorders. In various studies it has been found to be efficacious in insomnia in liver cirrhosis. It is to be started with low dose like 10 mg per day.
Other drug that has been recently found to be effective in insomnia in severe cirrhosis is Ramelteon. It is a melatonin agonist drug. In initial studies it has given proven results in insomnia in liver disease. Also in some studies it has been found to be useful in fastening healing in liver disease.
So please visit his doctor and take opinion regarding these medicines. They are comparatively safer.

Hope I cleared your doubt, If you have more questions you can ask again. If you are satisfied with conversation please review.

Thanks
Dr. Seikhoo Bishnoi MD
(Consultant Psychiatrist)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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Have Decompensated Cirrhosis And Insomnia. Will Histamines Help?

Hello
Welcome to Health Care Magic

Your husband is suffering from severe insomnia and is having decompensated hepatic cirrhosis. Management of insomnia in severe hepatic cirrhosis is really challenging.
Conventional medicines of sleep like Benzodiazepines as Clonazepam, Lorazepam or Zolpidem etc are usually avoided in severe cirrhosis because of risk to serious side effects due to poor metabolism of drugs. May lead to hepatic coma.

As you have mentioned about anti histaminic drugs, yes in a lot of studies they have found to be useful. Medicines like Hydroxyzine can be used. Hydroxyzine is a antihistaminic drug and it is used in anxiety disorders. In various studies it has been found to be efficacious in insomnia in liver cirrhosis. It is to be started with low dose like 10 mg per day.
Other drug that has been recently found to be effective in insomnia in severe cirrhosis is Ramelteon. It is a melatonin agonist drug. In initial studies it has given proven results in insomnia in liver disease. Also in some studies it has been found to be useful in fastening healing in liver disease.
So please visit his doctor and take opinion regarding these medicines. They are comparatively safer.

Hope I cleared your doubt, If you have more questions you can ask again. If you are satisfied with conversation please review.

Thanks
Dr. Seikhoo Bishnoi MD
(Consultant Psychiatrist)