![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by sdb on August 23, 2008, at 15:58:39
how do the most popular antihistamines for sleep (diphenhydramine, doxylamine) and other antihistamines differ in terms of side effects, efficacy, tolerance, length of efficacy, begin of effect, daytime drowsiness, dosage? Any personal experiences?
...and are there any personally recommendable relatively benign neuroleptics for sleep and how do they differ in terms of the same things mentioned above concerning antihistamines?
best wishes
sdb
Posted by med_empowered on August 23, 2008, at 19:21:01
In reply to antihistamines/neuroleptics 2 put somebody sleep, posted by sdb on August 23, 2008, at 15:58:39
Benadryl (diphenhydramine, others) is I think usually dosed out at 25-100mgs/nightly for sleep.
If you're trying to choose between an antihistamine and a neuroleptic for sleep, I'd say go for hydroxyzine. The dosage varies wildly (some people doze off at 50mgs; I used to take 200mgs), but once you hit the right dose its relatively safe stuff...if I recall correctly, higher doses can help with anxiety. It occasionally causes tardive dyskinesia, but I think the risk is a lot lower than with neuroleptics.
In some countries Nozinan (I think that's how its spelled) is used as a sedative. Its a densely sedating neuroleptic; the sleep-aid doses are pretty low, so I imagine the TD/NMS/EPS risks would be pretty small.
Low-dose Seroquel is popular for sleep, but at very low doses the stuff is just an extremely expensive antihistamine. Low dose of Thorazine are still sometimes used as a sleep aid.
Posted by sdb on August 24, 2008, at 1:55:03
In reply to Re: antihistamines/neuroleptics 2 put somebody sleep, posted by med_empowered on August 23, 2008, at 19:21:01
> Benadryl (diphenhydramine, others) is I think usually dosed out at 25-100mgs/nightly for sleep.
>
> If you're trying to choose between an antihistamine and a neuroleptic for sleep, I'd say go for hydroxyzine. The dosage varies wildly (some people doze off at 50mgs; I used to take 200mgs), but once you hit the right dose its relatively safe stuff...if I recall correctly, higher doses can help with anxiety. It occasionally causes tardive dyskinesia, but I think the risk is a lot lower than with neuroleptics.
> In some countries Nozinan (I think that's how its spelled) is used as a sedative. Its a densely sedating neuroleptic; the sleep-aid doses are pretty low, so I imagine the TD/NMS/EPS risks would be pretty small.
> Low-dose Seroquel is popular for sleep, but at very low doses the stuff is just an extremely expensive antihistamine. Low dose of Thorazine are still sometimes used as a sleep aid.in the literature hydroxyzine belongs to the same class as cetirizine (classic med used as anti-allergic) but with more sedating and less anticholinergic properties. Actually a good profile. I don't like so much the 1. class antihistamines like diphenhydramine, doxylamine etc. because these can people cause jerks, little seizures, urinary retention... There seem to be a lot of antihistamines used for vertigo, travel sickness and other stuff that could be used better as a sleep med than the official ones like diphenhydramine. Clearly there are the benzos and atypical benzos but it's better to avoid this IMO.
med_empowered: what's with the hangover effect the next morning due to its long half-life with hydroxyzine?
warm regards
sdb
Posted by yxibow on August 24, 2008, at 3:42:31
In reply to Re: antihistamines/neuroleptics 2 put somebody sleep, posted by sdb on August 24, 2008, at 1:55:03
> > Benadryl (diphenhydramine, others) is I think usually dosed out at 25-100mgs/nightly for sleep.
(Benadryl) diphenhydramine and (Dramamine) dimenhydrinate are basically the same drug with a chemical substitute, one is less powerful in some ways. There is also doxylamine succinate which is used in -some- versions of Unisom. Its cheaper to take the benadryl for allergies than for sleep by marketing sakes. But at any rate yes, up to about 75mg a night is safe.
> > If you're trying to choose between an antihistamine and a neuroleptic for sleep, I'd say go for hydroxyzine. The dosage varies wildly (some people doze off at 50mgs; I used to take 200mgs), but once you hit the right dose its relatively safe stuff...if I recall correctly, higher doses can help with anxiety. It occasionally causes tardive dyskinesia, but I think the risk is a lot lower than with neuroleptics.
I'm not sure there's a lot of risk of TD with Atarax, its slightly different and proto-antihistamine and they're not particularly pleasant agents in the end, for sleep. It was used at a time when other agents weren't available for anxiety mainly.
> > In some countries Nozinan (I think that's how its spelled) is used as a sedative. Its a densely sedating neuroleptic; the sleep-aid doses are pretty low, so I imagine the TD/NMS/EPS risks would be pretty small.
> > Low-dose Seroquel is popular for sleep, but at very low doses the stuff is just an extremely expensive antihistamine. Low dose of Thorazine are still sometimes used as a sleep aid.
If chlorpromazine (Largactil) is still used as a sleep aid, well I have no words -- a 25mg dose of Seroquel is infinitely safer and has nearly no AP effects at that level.
>
> in the literature hydroxyzine belongs to the same class as cetirizine (classic med used as anti-allergic) but with more sedating and less anticholinergic properties. Actually a good profile. I don't like so much the 1. class antihistamines like diphenhydramine, doxylamine etc. because these can people cause jerks, little seizures, urinary retention...
You are correct- urinary retention and other things can be caused by classic antihistamines and related alkaloids, they have a classic connection to atropine.certrizine is a vertigo medication, at least here, although meclizine is used more often, they are related and do have atropine properties I can tell you with "Dramamine II" (meclizine) -- perhaps certrizine has less. Meclizine is not terribly sleep-inducing.
There seem to be a lot of antihistamines used for vertigo, travel sickness and other stuff that could be used better as a sleep med than the official ones like diphenhydramine. Clearly there are the benzos and atypical benzos but it's better to avoid this IMO.
>
> med_empowered: what's with the hangover effect the next morning due to its long half-life with hydroxyzine?
>
> warm regards
>
> sdb
Posted by med_empowered on August 24, 2008, at 15:21:36
In reply to Re: antihistamines/neuroleptics 2 put somebody sleep » sdb, posted by yxibow on August 24, 2008, at 3:42:31
OK, I should have mentioned that I didn't really like hydroxyzine...I only took it b/c it was that or 30mgs of Restoril and I didn't want to take benzos anymore.
Hydroxyzine can cause **mad** hangovers; sometimes at 200mgs/nightly I'd doze off in the midlde of the day. The dreams it produced were vivied, bordering upon psychedleic. Although I was told it would have some sort of anti-anxiety effect, it pretty much made me more anxious.
That said: some people take the stuff on a regular basis for anxiety, sleep, and dermatological problems and don't have any problems.
Posted by Phillipa on August 24, 2008, at 17:35:04
In reply to hydroxyzine, posted by med_empowered on August 24, 2008, at 15:21:36
Is it anyway related to antivert and that was used for vertigo for me and did make me very tired?. Phillipa
Posted by sdb on August 25, 2008, at 5:37:56
In reply to Re: antihistamines/neuroleptics 2 put somebody sleep, posted by sdb on August 24, 2008, at 1:55:03
so which one is possibly the best antihistamine for sleep except diphenhydramine (and mirtazapine)? That stuff can people cause seizures and muscle jerks...
Posted by med_empowered on August 25, 2008, at 14:00:23
In reply to Re: antihistamines/neuroleptics 2 put somebody sleep, posted by sdb on August 25, 2008, at 5:37:56
I think seizures and muscle jerks can happen with any of the antihistamine and/or neuroleptic sedatives. Hydroxyzine is the cleanest non-benzo sedative I've tried...I mean, it still kind of sucked, but that might have been because of dosing and other meds I was taking.
The only other option I can think of would be Neurontin...a decent dose of that should knock you out for a while w/o causing the probs associated with anthistamines or neuroleptics. On the downside, when I took it, it was kind of unpredictable--worked too well one night, not so well the next. Still, its not a controlled substance, and its now in generic, so...maybe worth a shot?Good luck
Posted by sdb on August 26, 2008, at 14:57:09
In reply to Re: antihistamines/neuroleptics 2 put somebody sleep, posted by med_empowered on August 25, 2008, at 14:00:23
there were some tips by a neurologist professor and a former bundeswehr surgeon that I remember. mostly i use a mix of these habits to do sleep/awake.
at least for a veitstanz patient years ago, mirtazapine worked great!bye,
sdb in (holidays) soon
Posted by sdb on August 29, 2008, at 15:20:45
In reply to Re: antihistamines/neuroleptics 2 put somebody sleep, posted by sdb on August 26, 2008, at 14:57:09
> there were some tips by a neurologist professor and a former bundeswehr surgeon that I remember. mostly i use a mix of these habits to do sleep/awake.
> at least for a veitstanz patient years ago, mirtazapine worked great!
>
> bye,
>
> sdb in (holidays) soon
>discipline, looking in a light with full spectrum in the morning, warm socks, having warm (!), open the window, cold shower
<it doesn't always work>really approximately here:
http://maps.google.com/maps?t=h&hl=eng&ie=UTF8&ll=53.41377,5.300486&spn=0.009336,0.016758&z=16
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.