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PaperclipPerfector  4mo ago (text post)   2841 thread views

Small-Scale Question Sunday for December 31, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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Antihistamines. Do they reduce IQ?

Yes. The sad thing about the majority of pharmaceuticals in use today is that they're blunt instruments, hammers substituted for scalpels. Histamine, while we're mostly accustomed to encountering its effects from annoyances like hives or allergies, also functions as a neurotransmitter in the brain. It happens to modulate arousal and awakening in the brain, which is why sedation is/was a common side effect of antihistamines (more so in the older ones).

https://pubmed.ncbi.nlm.nih.gov/10856168/#:~:text=In%20a%20recent%20comparative%20trial,memory%2C%20vigilance%2C%20and%20speed.

In a recent comparative trial, subjects who were treated with the first-generation agent diphenhydramine were found to have significant performance deficits on tests of divided attention, working memory, vigilance, and speed. By contrast, subjects who were treated with the second-generation antihistamine loratadine performed as well as subjects who were treated with placebo. The sedative effects of the first-generation agents persist well into the next day and thus can potentially interfere with daytime performance and safety even when taken the night before. It is therefore recommended that patients whose occupations require vigilance, divided attention, or concentration receive only second-generation antihistamines.

The second-generation antihistamines are classified as "non-sedating", which is more or less correct, even if a few of them do have mild sedative effect, at least they're much better in that regard than the OGs. Keep in mind you're not thinking your best when you've got a reason to take them, such as during allergies or a cold.

I don't see any suggestion that the effect persists indefinitely, at least not for acute use at recommended doses, and you can avoid the worst of it by getting the better ones from the non-sedating class.

I've been taking Claritin (loratadine) but I still feel like I'm losing some bandwidth. I can't hold as many things on my mind as I usually do. Too bad it's either this or hives for now.

Levocetirizine is a non-sedating one that causes minimal cognitive effects, I'd recommend it. The paper I linked has examples of some others that couldn't be disentangled from placebo, so hopefully you find one that works for you.

Or you could go for a topical preparation? That should have fewer cognitive side effects.

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