site banner
PaperclipPerfector  4mo ago (text post)   2839 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.

3
Top Bottom Old Controversial Comments
Jump in the discussion.

No email address required.

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)?

You said safest, not the most effective, so I'm going to go with a glass of cold milk haha.

Truth be told, there isn't much in the way of good, almost perfectly safe choices, at least in OTC drugs that I'm aware of, and availability might well be in different in the States from what I'm used to. I could vaguely recommend l-theanine as a highly safe anxiolytic, even if it's not a sedative. Melatonin is highly dubious in terms of usefulness. But if you want to be knocked the fuck out, older antihistamines are your friend.

I don't have a particularly strong opinion on doxylamine beyond my theoretical knowledge, it's not the antihistamine used regularly where I hail from, but used in moderation? Doesn't seem all that bad. But it will almost certainly have the cognitive effects I mentioned above.

Just did some reading of actual studies. E.g. this meta-analysis from NCBI:

Research conducted among hospitalized older adults found that pharmacological (e.g., benzodiazepines) and non-pharmacological (e.g., diphenhydramine) medications resulted in an 18% and 22% respective increased rate of delirium among the sample.14 Also, research conducted among community-dwelling older adults found that non-pharmacological medication use was associated with lower cognitive function scores as compared to those not taking these components over a 10-year follow up period.15

Why should I find this plausible, rather than making the standard "correlation is not causation" point? Surely people with issues sleeping are in general less healthy, physically and/or psychologically. I don't see anything in there to indicate they controlled for anything.

Some references also seem to do nothing more than ask if people took any sleep aid, lumping together everything from melatonin (presumably very safe, maybe placebo) to daily benzos (clearly neither very safe nor a placebo).

Edit: I am bad at reading (maybe it's the doxylamine). They did control for things. But my question re causation stands. I feel like TheMotte is usually very skeptical, and I find myself surprised by the strength of multiple posters' convictions here.

while controlling for demographic covariates, including age (0= 65 up to 75 years of age; 1= 75 years of age and above), sex (0=male, 1=female), race (0=white, 1=non-white), and relationship status (0=widowed, single, or divorced, 1=living with partner or married). Third, we examined the relationship between sleep medication use and incident dementia while controlling for Model 2 demographic covariates and health conditions (0=no chronic conditions; 1=heart attack, 2=depression, 3=hypertension, 4=stroke, 5=diabetes). Depressive symptoms were measured using the Patient Health Questionnaire-2.34

What is this place?

This website is a place for people who want to move past shady thinking and test their ideas in a court of people who don't all share the same biases. Our goal is to optimize for light, not heat; this is a group effort, and all commentators are asked to do their part.

The weekly Culture War threads host the most controversial topics and are the most visible aspect of The Motte. However, many other topics are appropriate here. We encourage people to post anything related to science, politics, or philosophy; if in doubt, post!

Check out The Vault for an archive of old quality posts. You are encouraged to crosspost these elsewhere.


Why are you called The Motte?

A motte is a stone keep on a raised earthwork common in early medieval fortifications. More pertinently, it's an element in a rhetorical move called a "Motte-and-Bailey", originally identified by philosopher Nicholas Shackel. It describes the tendency in discourse for people to move from a controversial but high value claim to a defensible but less exciting one upon any resistance to the former. He likens this to the medieval fortification, where a desirable land (the bailey) is abandoned when in danger for the more easily defended motte. In Shackel's words, "The Motte represents the defensible but undesired propositions to which one retreats when hard pressed."

On The Motte, always attempt to remain inside your defensible territory, even if you are not being pressed.


New post guidelines

If you're posting something that isn't related to the culture war, we encourage you to post a thread for it. A submission statement is highly appreciated, but isn't necessary for text posts or links to largely-text posts such as blogs or news articles; if we're unsure of the value of your post, we might remove it until you add a submission statement. A submission statement is required for non-text sources (videos, podcasts, images).

Culture war posts go in the culture war thread; all links must either include a submission statement or significant commentary. Bare links without those will be removed.

If in doubt, please post it!


Rules


Recommended Posts And Communities

Recommended Realtime Chats