hydroxyzine hydrochloride / Generic mfg. - LARVOL DELTA

Evolving Treatment Strategies in Alagille Syndrome (ACG 2026) - "She was started on fat-soluble vitamins, ursodiol, hydroxyzine, and antihistamines for pruritus...After transferring care, maralixibat was recommended for continued pruritus, but the patient initially declined...Figure: Figure 2: Liver enzymes with persistently elevated AST, ALT, and GGT levels over time, consistent with ongoing cholestatic liver disease in the setting of Alagille syndrome. Liver enzymes have not been collected after initiation of odevixibat."

Cholestasis • Fibrosis • Hepatology • Immunology • Inflammation • Primary Biliary Cholangitis • Pruritus • JAG1 • NOTCH2

Labetalol-Associated Drug-Induced Liver Injury: A Case Report (ACG 2026) - "The patient was managed with ursodeoxycholic acid and hydroxyzine, with continued improvement noted on follow-up. Baseline liver function test levels were obtained on day of initiation (day 0). Labetalol was discontinued on the day of admission to the hospital (day 60)."

Case report • Clinical • Cardiovascular • Fibrosis • Genetic Disorders • Hepatology • Hypertension • Immunology • Inflammation • Liver Failure • Obesity

When Constipation Becomes a Renal Emergency: Stercoral Proctocolitis With Fecaloma-Induced Bilateral Hydroureteronephrosis and Obstructive Acute Kidney Injury (ACG 2026) - "Her medications included hydroxyzine, carbamazepine, mirtazapine, primidone, pregabalin, deutetrabenazine, and venlafaxine, contributing to a high anticholinergic burden. Massive fecal impaction causing stercoral proctocolitis and obstructive uropathy. Figure Footnote: The distended colon compresses the distal ureters resulting in bilateral hydroureteronephrosis (arrows)."

Acute Kidney Injury • Bipolar Disorder • Cardiovascular • CNS Disorders • Constipation • Endocrine Disorders • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Hypotension • Infectious Disease • Inflammatory Bowel Disease • Movement Disorders • Nephrology • Parkinson's Disease • Renal Disease

Ileal Bile Acid Transporter Inhibitors in Severe Refractory Cholestatic Pruritus in Adults: A Case Series Exploring Real-World Application Beyond Confirmed Progressive Familial Intrahepatic Cholestasis (ACG 2026) - "Odevixibat and maralixibat are two FDA-approved ileal bile acid transporter inhibitors (IBATi) for PFIC SRCP, which interrupt enterohepatic bile acid (BA) recirculation...Medications included mycophenolate mofetil, prednisone, ursodiol, hydroxyzine, and previous trial of seladelpar...Our case findings pose IBATi as promising therapy for adults with suspected or uncharacterized variants of PFIC with SRCP. Real-world data characterizing treatment response predictors in adults remain limited, and our cases further highlight the importance of genotypic associations, BA burden, and overlapping disease presentations as potential determinants of response requiring further study."

Clinical • Real-world • Real-world evidence • Autoimmune Hepatitis • Cholestasis • Dermatology • Dyslipidemia • Hepatology • Immunology • Inflammation • Primary Biliary Cholangitis • Pruritus • ABCB1 • ABCB4

Primary Care Prescribing Patterns for Benzodiazepines and Z-Drugs, and Evidence Gaps Concerning Hydroxyzine and Seasonality: A Systematic Review. (PubMed, Clin Pract) - " Prescription of medications with sedative and hypnotic properties remains an important part of primary healthcare practice. Yet, significant research gaps remain regarding hydroxyzine prescribing and the seasonal variation in hypnotic and sedative prescribing."

Journal • Review • CNS Disorders • Insomnia • Sleep Disorder

Comparison of the Utility of Amplitude-Spectral and Coherence Features of Psychotropic Drugs' Action on ECoG Signal for Pharmaco-EEG Based Drug Screening in Rats. (PubMed, Methods Protoc) - "The training set, relative to which the effects of the pharmacological agents from the test set were classified, were the matrices of effects of 12 pharmacological agents: the NMDA antagonist dizocilpine, the D2/D3 antagonists haloperidol and sulpiride, the M-anticholinergic tropicamide, the H1/5HT2A receptor blocker hydroxyzine, the acetylcholinesterase inhibitor galantamine, the alpha-2 adrenergic agonist dexmedetomidine, the alpha-2 adrenergic antagonist atipamezole, the adenosine receptor blocker caffeine and the GABA-mimetics aminophenylbutyric acid (phenibut), bromdihydrochlorophenylbenzodiazepine (phenazepam) and 5-ethyl-5-phenyl-2,4,6(1H,3H,5H)-pyrimidinetrione. The test set included various drugs with tropism for the targets of the training set drugs: dopamine receptor antagonists chlorpromazine, droperidol, tiapride and raclopride, H1-histamine blockers diphenhydramine and promethazine, 5-HT2-receptor blockers ritanserin and glemenserin, acetylcholinesterase..."

Journal • Preclinical • Pain

The 2025 revision of JPOS/JASCC clinical guidelines for delirium in adult patients with cancer: a summary of recommendations. (PubMed, Jpn J Clin Oncol) - "These revised clinical practice guidelines can serve as a practical framework for optimizing prevention, assessment, and management of delirium in adult patients with cancer in Japan."

Clinical guideline • Journal • CNS Disorders • Oncology • Palliative care

RELIEF OF PSYCHOEMOTIONAL STRESS USING XENON SEDATION (clinicaltrials.gov) - P1 | N=140 | Completed | Sponsor: The S.N. Fyodorov Eye Microsurgery State Institution | Trial completion date: Apr 2026 ➔ Sep 2026 | Trial primary completion date: Jan 2026 ➔ Sep 2026 | Recruiting ➔ Completed

Trial completion • Trial completion date • Trial primary completion date • Anesthesia • Psychiatry

The Effect of Psychotropic Agents on Sick Sinus Syndrome: A Case Report. (PubMed, Cureus) - "A review of her regimen identified several cardiac safety concerns: quetiapine's potential interference with flecainide, hydroxyzine-associated QT prolongation, and bupropion's CYP2D6 inhibition that could increase flecainide levels. Management prioritized minimizing arrhythmogenic risk by discontinuing quetiapine, restricting hydroxyzine to low doses, and continuing melatonin, supplemented by stress testing and reassessment of psychotropic options. This case highlights the importance of careful psychotropic selection in patients with SSS, favoring lower-risk agents, such as mirtazapine, which is one of the safest among several possible alternatives, while maintaining close ECG monitoring and coordinated cardiology and psychiatry collaboration to reduce drug-drug interactions and optimize safety."

Journal • Cardiovascular • CNS Disorders • General Anxiety Disorder • Insomnia • Mood Disorders • Psychiatry • Sleep Disorder • Ventricular Tachycardia

Seizure-like Activity During Interscalene Block in a 14-Year-Old (ASA 2026) - "A 14-year-old male wrestler with asymptomatic SCAD deficiency, ADHD, and depression on gabapentin, duloxetine, hydroxyzine, doxycycline, and oxycodone underwent right shoulder arthroscopy. After midazolam 2 mg IV and fentanyl 100 mcg IV, a right interscalene block with 20 mL 0.5% bupivacaine was placed...Surgery was later completed uneventfully. Findings raise concern for local anesthetic systemic toxicity despite standard dosing and highlight patient-specific seizure susceptibility."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Depression • Epilepsy • Orthopedics

Integrative transcriptomic and machine learning analysis identifies S100A8 as a key hub bridging peripheral inflammation and synaptic deficits in schizophrenia. (PubMed, Psychiatry Res) - "Molecular docking identified hydroxyzine as a candidate S100A8 ligand. These convergent findings establish S100A8 as a hub linking peripheral immune dysregulation to microglial activation and synaptic pathology in SCZ, highlighting it as a candidate biomarker and therapeutic target."

Journal • Review • CNS Disorders • Inflammation • Psychiatry • Schizophrenia • C1QA • CD68 • CX3CR1 • S100A8 • S100A9 • SYP

LC-MS/MS Quantification of Five Antihistamines in Antemortem Blood: Method Validation and Application. (PubMed, J Anal Toxicol) - "A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for five first-generation H1 antihistamines: chlorpheniramine, diphenhydramine, doxylamine, hydroxyzine, and promethazine. Selected case reports are presented to demonstrate the applicability of the method. The high percentage of polysubstance cases, range of concentrations, and delayed sample collection in DFC cases underscore the importance of a sensitive and reproducible method for these first-generation antihistamines, especially in human-performance casework."

Journal • Alzheimer's Disease • Anesthesia • CNS Disorders • Cognitive Disorders

Post-Pandemic Trends in Pediatric Mental Health Treatment: A Nationwide Study. (PubMed, JAACAP Open) - "Among treatment-engaged youth, adolescents had higher antidepressant use (32%-36%) and hydroxyzine use (7%-10%), with reduced benzodiazepine use (7%-4%). Substantial and sustained increases in pediatric behavioral health treatment persisted beyond the acute pandemic period, concentrated among female individuals and driven primarily by antidepressant prescribing. These patterns warrant monitoring and targeted interventions to address sex disparities and persistent racial and ethnic inequities."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Infectious Disease • Mental Retardation • Novel Coronavirus Disease • Pediatrics • Psychiatry

Oculogyric Crisis and Torticollis Temporally Associated With Short-Term Coadministration of Fluoxetine and Hydroxyzine in a Child With Attention-Deficit/Hyperactivity Disorder. (PubMed, J Clin Psychopharmacol) - No abstract available

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Agentic AI for Structural Elucidation and Discovery of Drug Metabolites from Mass Spectrometry Data. (PubMed, bioRxiv) - "The agent predicted, and we experimentally confirmed, a phosphorylated hydroxyzine, an acetaminophen-p-coumaric acid ester, and identified two new oxidative ibuprofen-carnitine conjugates from public repositories. These results demonstrate that LLM-driven agentic reasoning, when combined with domain expertise, can indeed generate experimentally testable structural hypotheses for previously uncharacterized metabolites leveraging pan repository data."

Journal

A REAL-WORLD, PROSPECTIVE EVALUATION OF MARALIXIBAT THERAPY IN PEDIATRIC ALAGILLE SYNDROME: CLINICAL AND LIVER ELASTOGRAPHY OUTCOMES (ESPGHAN 2026) - "Treatment with ursodeoxycholic acid, rifampicin, hydroxyzine, and vitamins were maintained. Larger cohorts with longer observation are needed to clarify the long-term influence of Maralixibat on liver stiffness trajectories in ALGS. Contact e-mail address [email protected]"

Clinical • Real-world • Real-world evidence • Cholestasis • Fibrosis • Hepatology • Immunology • Pediatrics • Pruritus

Not so innocent after all: H1-antihistamine-induced Fixed Drug Eruption confirmed by lesional Patch Testing (BAD 2026) - "H1-antihistamines can be grouped by chemical structure into alkylamines (chlorphenamine), piperazines (hydroxyzine and cetirizine) and piperidines (loratadine and fexofenadine)...Symptoms persisted despite oral prednisolone but improved rapidly after stopping antihistamines...Repeat patch testing with fexofenadine and diphenhydramine is planned to assess cross-sensitivity. This case describes a rare antihistamine-associated fixed drug eruption with postulated class-related crossreactivity in a presumed safe drug class and highlights in situ patch testing as a safe diagnostic tool."

Immunology • Inflammation • Urticaria

Temozolomide induced urticarial reaction: Case series and approach to management of a unique drug side effect (ISPNO 2026) - "She required treatment with intravenous corticosteroids and epinephrine, resulting in complete resolution of her symptoms...Three days after completing cycle 5 of maintenance TMZ, she developed an urticarial eruption that resolved with cetirizine, hydroxyzine and diphenhydramine... All cases demonstrated onset of urticaria occurring approximately three days after TMZ exposure, with two of them having delayed presentation after tolerating drug for multiple cycles. While antihistamine premedication mitigated symptoms, hypersensitivity reactions recurred in patients who continued therapy, highlighting the importance of recognition and management of delayed TMZ hypersensitivity."

Adverse events • Clinical • Brain Cancer • Cardiovascular • CNS Tumor • Dermatology • Ependymoma • Glioma • High Grade Glioma • Immunology • Solid Tumor • Urticaria

Not so innocent after all: H1-antihistamine-induced Fixed Drug Eruption confirmed by lesional Patch Testing (BAD 2026) - "H1-antihistamines can be grouped by chemical structure into alkylamines (chlorphenamine), piperazines (hydroxyzine and cetirizine) and piperidines (loratadine and fexofenadine)...Symptoms persisted despite oral prednisolone but improved rapidly after stopping antihistamines...Repeat patch testing with fexofenadine and diphenhydramine is planned to assess cross-sensitivity. This case describes a rare antihistamine-associated fixed drug eruption with postulated class-related crossreactivity in a presumed safe drug class and highlights in situ patch testing as a safe diagnostic tool."

Immunology • Inflammation • Urticaria

Perioperative management in elderly breast cancer patients with mental illness (JBCS 2026) - "In the S group, additional medications included a single dose of risperdal in 3 cases, atarax P and haloperidol in 2 cases, quetiapine tablets in 1 case, and zolpidem tablets in 1 case. Postoperative hospital stays also tended to be longer. Elderly breast cancer patients with mental illness require more careful attention during the perioperative period compared to non-elderly patients."

Clinical • Alzheimer's Disease • Breast Cancer • CNS Disorders • Dementia • Depression • Developmental Disorders • Mental Retardation • Oncology • Schizophrenia • Solid Tumor

Blood–brain barrier permeability of antihistamines and risk of depression in children and adolescents: a real-world cohort study (CINP 2026) - "Exposure groups were defined by antihistamine BBB permeability: the low-BBB cohort (fexofenadine, bilastine, ebastine, olopatadine, acrivastine) and the high-BBB cohort (diphenhydramine, chlorpheniramine, hydroxyzine, promethazine, doxylamine, triprolidine, pheniramine). This large-scale, real-world analysis suggests that high-BBB-penetrant antihistamines may confer an elevated risk of depression in children and adolescents with allergic rhinitis. The absence of associations for negative-control outcomes supports the internal validity of this finding and implicates BBB permeability as a plausible factor influencing psychiatric vulnerability. Clinically, these results highlight the importance of considering BBB penetrability when selecting antihistamines for pediatric patients, particularly those with emotional or behavioral risk factors."

Clinical • Real-world • Real-world evidence • Acne Vulgaris • Allergic Rhinitis • CNS Disorders • Depression • Immunology • Inflammation • Mental Retardation • Mood Disorders • Psychiatry

A Case of Sustained Ventricular Tachycardia Soon after Initiation of Teriparatide (ENDO 2026) - "Clinical Case: A 73-year-old woman with a history of severe postmenopausal osteoporosis diagnosed eight years prior and treated with multiple doses of zoledronic acid, was referred to endocrinology for continued bone mineral density decline...Her medication regimen included trazodone, hydroxyzine, amitriptyline, and cyclobenzaprine, all of which have been associated with QT prolongation and ventricular arrythmias...After two amiodarone boluses and one defibrillation shock, she converted to sinus rhythm... It is unlikely that teriparatide increases risk of ventricular tachycardia. While atrial arrhythmias are associated with teriparatide use, ventricular arrhythmias due to treatment have not been reported. Thus, underlying predisposing cardiovascular conditions or cardiotoxic medications should be investigated in patients with major cardiac adverse events."

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Endocrine Disorders • Heart Failure • Hypertension • Metabolic Disorders • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Pulmonary Disease • Ventricular Tachycardia

Substitution Patterns After Discontinuation of CNS-Active Medications in Older Adults in Primary Care. (PubMed, J Am Geriatr Soc) - "Of medication discontinuations with a substitution, one-quarter were to at least one potentially inappropriate medication. This finding highlights the need for additional guidance for prescribers to ensure safe deprescribing of CNS-active medications."

Journal

Azole antifungals as rare triggers of acute generalized exanthematous pustulosis: a systematic review (EAACI 2026) - "Fluconazole (46%) and itraconazole (36%) were the most frequently triggers, followed by ketoconazole (9%) and miconazole (9%)...Management consisted of discontinuation of the azole, along with topical or systemic corticosteroids and antihistamines, such as hydrocortisone, methylprednisolone, and hydroxyzine...Although the clinical course is generally self-limited following drug discontinuation and supportive therapy, severe systemic complications may occur. Awareness of azole-associated AGEP is important for early recognition, withdrawal of the offending agent, and appropriate management to prevent morbidity."

Late-breaking abstract • Review • Dermatomyositis • Immunology • Myositis • Psoriasis

Management of sleep disturbances in the ICU: a secondary analysis of the ESPRIT study. (PubMed, Anaesth Crit Care Pain Med) - "Sleep disturbances are common in ICUs, yet routine screening and structured management remain rare. Standardized, nurse-led screening and broader adoption of non-pharmacological protocols are needed to improve sleep quality and patient outcomes."

Journal • CNS Disorders • Critical care • Sleep Disorder