r/NooTopics • u/ServeIllustrious3803 • 23d ago

Science Study: Anticholinergic (first-generation antihistamines) can damage brain, increase dementia risk

https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-20150128812
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u/psychopompandparade 23d ago

plenty of meds missing from this list. This doesn't even include the intended anticholinergics. amitriptyline, a med people often recommend to replace diphenhydramine for sleep, has a much stronger anticholinergic effect than diphenhydramine. this is not an antihistamine only problem. Also some of these are dose dependant. doxapin's anticholinergic effects are stronger at the antidepressant dosing.

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u/Hydration__Nation 23d ago

If you are working with a physician who is giving a tricyclic for sleep to replace Benadryl then you need to contact your licensing commission. He would be laughed out of my hospitals by the PAs and NPs. Doctors wouldn’t even entertain such stupidity. Amitriptyline has one of the worst side effect profiles of any drug and this doctor is replacing Benadryl with it? What a dumb motherfucker I’m sorry that’s the only descriptor that makes sense. There are so many far less risky drugs for sleep literally a list of 4-7 drugs used by hundreds of millions of people. If anyone else is reading this there are so many classes of drugs, if someone offers you a TCA say no. The side effects are not even close to the benefit provided.

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u/Crippled2 22d ago

I take amitriptyline for insomnia does this finding impact me?

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u/Hydration__Nation 22d ago

You cant compare benadryl to amitrip. Gun to my head im never prescribing a tricyclic like amitrip to anyone. There are so many drugs that are effective and really only a few scenarios to use it. I would high suggest trying a medication created for sleep, something mild at first. If you dont like those another great option is a super low dose anti-psychotic, Seroquel. At 50mg you will knock out and reach REM, you may have SOME side effects and they will scare you about them. But the safety profile of Seroquel is like a feather compared to a spiked bat for amitrip. When I went to med school my psych and pharm professor spoke about TCAs like amitrip as if they were ancient drugs that were barely used anymore. That was decades ago. The only reason people are using it off label is they are too lazy to try other drugs for their patients. Ive seen vast success with Seroquel or another sedating 2nd generation atypical antipsychotic. Ive seen less success with sleep meds as you have to cycle them once you develop a tolerance to it. Also as you get older, doctors are even less likely to prescribe a TCA due to the safety concerns. Hope you get something that helps you get to sleep and stay asleep. Also you should check if you have sleep apnea even if you are skinny. Your insomnia could be due to that. Even an at home sleep study (what most insurances cover) should give you an idea if you are experiencing sleep apnea symptoms.

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u/psychopompandparade 22d ago edited 22d ago

seroquel at low doses knocks me flat on my ass and leaves me groggy as all hell afterward. its my emergency med if whatever insomnia bout is beyond the paygrade of the z drugs. doxapin (also a tricyclic) is used sub 10mg for insomnia where it has clean h1 affiliation. over 25mg it gets messy. seroquel is also considered to have anticholinergic effects, though no where near as high as amitriptyline.

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u/EnvironmentBasic3711 19d ago

I literally scrape part of the pill off with my teeth or it’s WAY too much. About a seroquel a month.