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PaperclipPerfector  4mo ago (text post)   2838 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.

Related followup: what is the safest OTC sleep aid? Thoughts on doxylamine (unisom)?

This really depends on what your use case is.

If you're worried I would go for some kind of antihistamine since even the non-benzo benzo derivatives have higher risks of death associated with them.

On the other hand, if you're driving to work I would be careful with the antihistamines. They really do make you drowsy in the morning, especially at the higher doses. The effect does go away and I've had no trouble performing at work after taking them but I almost crashed my car once... If you take PT, bike or get driven to work they're great imo.

Finally, I hope it goes without saying that sleeping aids really shouldn't be something one takes every day, for a whole host of reasons, and if you have to take one for extended periods you should really stay away from benzodiazepines and their derivates.

If you take PT, bike or get driven to work they're great imo.

with cycling it is fine only when you have cycleways separated from roads without real pedestrian/cycling traffic on them

falling under car while on bicycle is a poor idea

That is true to an extent but cycling by it's nature also keeps you awake and alert in a way that driving doesn't. The lingering effect isn't that strong and I've never been worried in the slightest or close to an accident when biking. In a car people start drifting off by just being regular tired.

Furthermore, it's not the high stress environment that is the highest risk imo, it's when you're in steady pace traffic.

In the end this is something one has to figure out for oneself and it depends on how one reacts to the medication and being careful is prudent. Smaller doses are advisable anyway and they significantly reduce risk and severity of morning drowsiness.

definitely makes sense, more than what I expected to be reasoning (that on bicycle hitting others will cause much lesser harm), thanks for clarifying

(I have quite limited experience with car driving)

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