4 ms·

Doxylamine succinate is a potent anticholinergic drug, as are (IIRC) all other OTC antihistamines that cause drowsiness. Long term use of such drugs have been

Doxylamine succinate is a potent anticholinergic drug, as are (IIRC) all other OTC antihistamines that cause drowsiness. Long term use of such drugs have been linked to dementia later in life. I would at least read some of the literature and re-evaluate whether using drugs like this to sleep on a regular basis is worthwhile.

themodelplumber 8y ago
Already done. No dementia in family history, and the actual literature leaves much to be desired in terms of qualitative result. By the way I discourage the use of the term "linked" in light conversation as it has recently and unfortunately become a socio-culturally appropriated term indicating proof of causality. That a linkage exists often means far less than most people think, and this could immediately impact their health-related decision-making for the worse.
- GordonS 8y ago
  I didn't read the paper since it first came out (1-2 years ago?), but I seem to recall a clear causal link was found?
  - themodelplumber 8y ago
    I would really encourage you to review the study again. For example, the authors themselves acknowledged a lot of legitimate reader concerns with the inclusion of this statement: "These observational studies have 4 important limitations. First, current anticholinergic use was ascertained at study entry and periodically during follow-up only by conducting a medication inventory. Second, these studies lacked information about the dose and duration of anticholinergic use. Third, these studies had short follow-up periods. This last point is important because the pathophysiological changes in the brains of patients with AD require several years to occur. Finally, these studies did not take into account that certain anticholinergics are used to manage insomnia and depression, prodromal conditions that can be seen in early but undiagnosed dementia, leading to protopathic bias." I had other concerns as well, and these items alone are a pretty big deal. Like I said above, the _quality_ of the establishment of a "link" is really leaving much to be desired here. This is barely even legitimate science, where any kind of causality is concerned. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091745 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
    - GordonS 8y ago
      Thanks for taking the time to provide a summary - I will indeed take another look (I have hydroxyzine at night, so it's very relevant for me)
Legogris 8y ago
Something that I have not been able to get an answer to; could the long-term effects of regular antihistamine use be mitigated by supplementing with choline in the morning/daytime?
- pmiller2 8y ago
  My initial thought would be probably not, because anticholinergic drugs work by blocking cholinergic receptors. No matter how much choline you eat, a blocked receptor is still blocked, until the drug lets go and gets broken down. That said, eating a few extra eggs in the morning probably wouldn't hurt. (Of course, this is not medical advice, because I'm not a doctor or a biological scientist of any sort.)

themodelplumber 8y ago

Already done. No dementia in family history, and the actual literature leaves much to be desired in terms of qualitative result. By the way I discourage the use of the term "linked" in light conversation as it has recently and unfortunately become a socio-culturally appropriated term indicating proof of causality. That a linkage exists often means far less than most people think, and this could immediately impact their health-related decision-making for the worse.

GordonS 8y ago
I didn't read the paper since it first came out (1-2 years ago?), but I seem to recall a clear causal link was found?
- themodelplumber 8y ago
  I would really encourage you to review the study again. For example, the authors themselves acknowledged a lot of legitimate reader concerns with the inclusion of this statement: "These observational studies have 4 important limitations. First, current anticholinergic use was ascertained at study entry and periodically during follow-up only by conducting a medication inventory. Second, these studies lacked information about the dose and duration of anticholinergic use. Third, these studies had short follow-up periods. This last point is important because the pathophysiological changes in the brains of patients with AD require several years to occur. Finally, these studies did not take into account that certain anticholinergics are used to manage insomnia and depression, prodromal conditions that can be seen in early but undiagnosed dementia, leading to protopathic bias." I had other concerns as well, and these items alone are a pretty big deal. Like I said above, the _quality_ of the establishment of a "link" is really leaving much to be desired here. This is barely even legitimate science, where any kind of causality is concerned. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091745 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
  - GordonS 8y ago
    Thanks for taking the time to provide a summary - I will indeed take another look (I have hydroxyzine at night, so it's very relevant for me)

Legogris 8y ago

Something that I have not been able to get an answer to; could the long-term effects of regular antihistamine use be mitigated by supplementing with choline in the morning/daytime?

pmiller2 8y ago
My initial thought would be probably not, because anticholinergic drugs work by blocking cholinergic receptors. No matter how much choline you eat, a blocked receptor is still blocked, until the drug lets go and gets broken down. That said, eating a few extra eggs in the morning probably wouldn't hurt. (Of course, this is not medical advice, because I'm not a doctor or a biological scientist of any sort.)