The medication ingredients in question are doxylamine succinate, which is found in certain sleep aids (like Unisom) and allergy medications, like first-generation antihistamines (such as hydroxyzine, or Vistaril/Atarax, and diphenhydramine, or Benadryl. It can have cognitive side effects in the long term and short term, though the former are more serious—think increased dementia risk.“Doxylamine succinate, a first-generation antihistamine, can have negative impacts on brain health, especially when patients use high doses, frequently and for a long period,” confirms Dr. Duyen Nguyen, DO, an allergist at Memorial Hermann.Immediate impacts, she says, include confusion, drowsiness and dizziness. Prolonged use, however, can lead to cognitive decline, memory loss, increased risk of dementia and delirium, especially in older patients.Related: This 3-Minute Habit Could Help You Sleep Through the Night
“These medications block acetylcholine, a neurotransmitter essential for memory, attention and learning,” explains Dr. Chris Allen, MD, sleep science advisor at Aeroflow Sleep, a board-certified sleep medicine physician and a pediatric neurologist. “Over time, this interference may contribute to structural and functional changes in the brain.”
Related: New Study Reveals Surprising Factor That May Increase Dementia Risk
In fact, Dr. Nguyen would say it’s “very risky” for elderly patients to take a high dosage of doxylamine succinate for a prolonged period. The level of risk depends on the dose, duration and individual factors, McDanel adds, like age, other medications taken and overall brain health.
Since the safety profile is so individualized, your best bet is to talk to your primary care provider, who knows your history.
Safer, Effective Alternatives
If you need more long-term support with allergies or sleep, other options are probably safer bets. Ahead, doctors share tips and treatments to consider.
Second-generation antihistamines are also less likely to make you drowsy, a major complaint with first-generation antihistamines. “Allergists often recommend these over first-generation antihistamines due to the lower chance of causing sedation, while maintaining the same, if not more, clinical efficacy for treating allergic conditions,” Dr. McDanel adds.
Additionally, Dr. Nguyen mentions prescription medication, such as montelukast, and allergy shots. “Allergy immunotherapy (allergy shots) is the most effective treatment for moderate to severe allergies,” she adds.
For sleep
If you struggle with sleep, Dr. Allen has several suggestions. His first recommendation is cognitive behavioral therapy for insomnia (CBT-I). “This is the gold standard for chronic sleep problems,” he says.
Establishing a consistent sleep routineLimiting screen time before bedAvoiding stimulants late in the dayCreating a cool, dark sleeping environment Talking to a doctor about medication (or supplements) if necessary
Dr. Nguyen agrees that CBT-I and good sleep habits are good options. “This is considered the safest way to treat insomnia,” she explains.
Up Next:
Related: ‘I’m a Brain Scientist, and This 2-Minute Habit Makes Me Feel 10 Times Sharper’
Sources
Dr. Duyen Nguyen, DO, an allergist Dr. Sanjay Kamboj, MD, an allergy and immunology specialist Dr. Chris Allen, MD, a board-certified sleep medicine physician and a pediatric neurologistDr. Deanna McDanel, PharmD, a clinical pharmacy specialist Cumulative Use of Strong Anticholinergics and Incident Dementia, JAMA Internal Medicine Read More Details
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