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Relationship between sedation and pupillary function: comparison of diazepam and diphenhydramine

Relationship between sedation and pupillary function: comparison of diazepam and diphenhydramine
Relationship between sedation and pupillary function: comparison of diazepam and diphenhydramine
AIMS: To examine the relationship between sedation and pupillary function by comparing the effects of diazepam and diphenhydramine on arousal and pupillary activity. METHODS: Fifteen male volunteers participated in three weekly sessions in which they received (i) diazepam 10 mg, (ii) diphenhydramine 75 mg and (iii) placebo, according to a balanced, double-blind protocol. Pupil diameter was measured with infrared pupillometry under four luminance levels. Alertness was assessed by visual analogue scales (VAS) and by critical flicker fusion frequency (CFFF). Blood pressure, heart rate and skin conductance were recorded by conventional methods. Data were analysed with analysis of variance (anova) with multiple comparisons. RESULTS: There were significant effects of ambient luminance (F3,42 = 305.7, P < 0.001) and treatment condition (F2,28 = 9.0, P < 0.01) on pupil diameter; diphenhydramine caused miosis at all luminance levels (P < 0.05). The light reflex response was not affected. Both active drugs reduced the pre-post treatment changes compared with placebo [mean difference from placebo (95% confidence interval)]: in CFFF (Hz), diazepam -0.73 (-1.63, 0.17), diphenhydramine -1.46 (-2.40, -0.52); and VAS alertness (mm), diazepam -11.49 (-19.19, -3.79), diphenhydramine -19.83 (-27.46, -12.20). There were significant effects of both session (F2,26 = 145.1, P < 0.001) and treatment (F2,26 = 5.5, P < 0.01) on skin conductance; skin conductance was reduced by both drugs (P < 0.05). CONCLUSIONS: The miosis by diphenhydramine and the reduction in skin conductance by both drugs may indicate central sympatholytic effects. A lack of a sympatholytic effect of diazepam on the pupil may be due to the masking of the miosis by mydriasis resulting from the inhibition of the parasympathetic output to the iris
adolescent, pupil, heart rate, psychiatry, double-blind method, arousal, female, methods, hypnotics and sedatives, drug effects, diazepam, humans, adult, treatment, flicker fusion, blood pressure, pupillary, male, reflex, galvanic skin response, comparison, analysis, mydriatics, diphenhydramine, blood, pharmacology, photic stimulation
0007-1188
752-760
Hou, R.H.
470bdcbc-93a9-4dad-aac5-26d455c34376
Scaife, J.
24fdad0f-8011-46e5-9a2a-3c0f30503840
Freeman, C.
deca0fee-b76a-4fc2-a276-ecedf49c5a24
Langley, R.W.
579cc42e-972f-4422-952f-1c76ecc4b4e3
Szabadi, E.
cff688f8-264f-4ca3-a2c4-cb10930f1956
Bradshaw, C.M.
0baafd10-0e91-4113-b90b-27132bd77305
Hou, R.H.
470bdcbc-93a9-4dad-aac5-26d455c34376
Scaife, J.
24fdad0f-8011-46e5-9a2a-3c0f30503840
Freeman, C.
deca0fee-b76a-4fc2-a276-ecedf49c5a24
Langley, R.W.
579cc42e-972f-4422-952f-1c76ecc4b4e3
Szabadi, E.
cff688f8-264f-4ca3-a2c4-cb10930f1956
Bradshaw, C.M.
0baafd10-0e91-4113-b90b-27132bd77305

Hou, R.H., Scaife, J., Freeman, C., Langley, R.W., Szabadi, E. and Bradshaw, C.M. (2006) Relationship between sedation and pupillary function: comparison of diazepam and diphenhydramine. British Journal of Pharmacology, 61 (6), 752-760. (doi:10.1111/j.1365-2125.2006.02632.x).

Record type: Article

Abstract

AIMS: To examine the relationship between sedation and pupillary function by comparing the effects of diazepam and diphenhydramine on arousal and pupillary activity. METHODS: Fifteen male volunteers participated in three weekly sessions in which they received (i) diazepam 10 mg, (ii) diphenhydramine 75 mg and (iii) placebo, according to a balanced, double-blind protocol. Pupil diameter was measured with infrared pupillometry under four luminance levels. Alertness was assessed by visual analogue scales (VAS) and by critical flicker fusion frequency (CFFF). Blood pressure, heart rate and skin conductance were recorded by conventional methods. Data were analysed with analysis of variance (anova) with multiple comparisons. RESULTS: There were significant effects of ambient luminance (F3,42 = 305.7, P < 0.001) and treatment condition (F2,28 = 9.0, P < 0.01) on pupil diameter; diphenhydramine caused miosis at all luminance levels (P < 0.05). The light reflex response was not affected. Both active drugs reduced the pre-post treatment changes compared with placebo [mean difference from placebo (95% confidence interval)]: in CFFF (Hz), diazepam -0.73 (-1.63, 0.17), diphenhydramine -1.46 (-2.40, -0.52); and VAS alertness (mm), diazepam -11.49 (-19.19, -3.79), diphenhydramine -19.83 (-27.46, -12.20). There were significant effects of both session (F2,26 = 145.1, P < 0.001) and treatment (F2,26 = 5.5, P < 0.01) on skin conductance; skin conductance was reduced by both drugs (P < 0.05). CONCLUSIONS: The miosis by diphenhydramine and the reduction in skin conductance by both drugs may indicate central sympatholytic effects. A lack of a sympatholytic effect of diazepam on the pupil may be due to the masking of the miosis by mydriasis resulting from the inhibition of the parasympathetic output to the iris

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More information

Published date: 2006
Keywords: adolescent, pupil, heart rate, psychiatry, double-blind method, arousal, female, methods, hypnotics and sedatives, drug effects, diazepam, humans, adult, treatment, flicker fusion, blood pressure, pupillary, male, reflex, galvanic skin response, comparison, analysis, mydriatics, diphenhydramine, blood, pharmacology, photic stimulation

Identifiers

Local EPrints ID: 62417
URI: http://eprints.soton.ac.uk/id/eprint/62417
ISSN: 0007-1188
PURE UUID: 0a3cea5f-1cfb-4507-9d78-2a384ae655e4
ORCID for R.H. Hou: ORCID iD orcid.org/0000-0001-6127-1478

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Date deposited: 05 Sep 2008
Last modified: 16 Mar 2024 03:55

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Contributors

Author: R.H. Hou ORCID iD
Author: J. Scaife
Author: C. Freeman
Author: R.W. Langley
Author: E. Szabadi
Author: C.M. Bradshaw

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