Common OTC Meds May Pose Brain Health Risks
Many consider over-the-counter (OTC) medications harmless, but some can impact brain health. Medical experts are cautioning against a specific OTC drug found in sleep aids and allergy treatments due to potential long-term cognitive effects.
The Risky OTC Ingredient
The ingredient of concern is doxylamine succinate, present in some sleep aids, like Unisom, and first-generation antihistamines, such as Benadryl. These can lead to short-term confusion and dizziness and potentially increase dementia risk over time.
“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,”
—Dr. Duyen Nguyen, DO, Allergist
Prolonged use may cause memory loss and cognitive decline, especially in older people. A 2015 study in JAMA Internal Medicine determined a link between cumulative anticholinergic use and a higher dementia risk.
Understanding the Mechanism
Dr. Chris Allen, MD, explains that these medications impede acetylcholine, which is vital for memory and learning. This disruption could lead to structural and functional changes in the brain over time.
Dr. Deanna McDanel, PharmD, adds that this is a key chemical promoting wakefulness, so blocking it causes drowsiness. This drowsiness can cause an increased risk of accidents, especially in seniors.
While the medication can be safe in minimal doses for a short duration, and is even recommended for pregnant women, risks increase with long-term use. Consult your doctor to assess individual risk, as risk depends on dosage, duration, and individual factors.
Safer Alternatives to Consider
For allergy relief, consider newer antihistamines such as loratadine or cetirizine, which are less likely to cross the blood-brain barrier. Second-generation antihistamines are often recommended, as they cause less drowsiness.
For sleep issues, Dr. Allen suggests cognitive behavioral therapy for insomnia (CBT-I). Sleep hygiene, including a consistent routine and limiting screen time before bed, is also critical. The National Institutes of Health reports that about 30% of adults experience symptoms of insomnia.
Dr. Nguyen also endorses CBT-I and good sleep habits as the safest approach to treat insomnia. Occasional use of the medication is not known to be harmful for healthy adults, but avoid long-term use.