Is your brain at risk? Doctors urge caution with this common over-the-counter medication
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Disclaimer: The information provided in this article is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or other qualified healthcare providers with any questions you may have regarding a medical condition or before making any changes to your health regimen.
Most of us assume that if a medication is sold over the counter, it must be safe.
After all, you can pick it up at any pharmacy or grocery store—no prescription needed.
But doctors are now warning that some of these everyday remedies may not be as harmless as they seem, especially when used frequently or for long periods of time.
If you regularly rely on sleep aids or allergy medications, this is one warning you’ll want to pay attention to.
A specific ingredient found in many popular OTC products may be putting your brain health in jeopardy.
The ingredient is doxylamine succinate, a first-generation antihistamine found in common sleep aids like Unisom and some allergy medications, including diphenhydramine (better known as Benadryl) and hydroxyzine (Vistaril or Atarax).
While these medications can provide short-term relief, medical experts caution that regular or long-term use may come with serious side effects for your brain.
“Doxylamine succinate, a first-generation antihistamine, can have negative impacts on brain health—especially when patients use high doses frequently or over extended periods,” says Dr. Duyen Nguyen, an allergist with Memorial Hermann.
Short-term side effects like confusion, drowsiness, and dizziness are fairly well-known.
But what worries doctors more is the growing evidence linking long-term use to memory problems, cognitive decline, and even increased risk of dementia—particularly in older adults.
Dr. Sanjay Kamboj, a specialist in allergy and immunology, adds: “While occasional use of doxylamine in healthy adults is typically safe, frequent use can lead to neurodegenerative changes or worsen existing dementia risk factors.”
The keyword here is occasional—not nightly, not every allergy season.
The concern around doxylamine succinate isn’t just theoretical.
A landmark 2015 study published in JAMA Internal Medicine showed that people with higher cumulative use of anticholinergic medications—which includes doxylamine—had a significantly increased risk of developing dementia.
“These medications block acetylcholine, a neurotransmitter critical for memory, learning, and focus,” explains Dr. Chris Allen, a sleep medicine physician.
“Over time, this disruption can lead to structural and functional changes in the brain.”
Acetylcholine also promotes alertness and wakefulness.
So while blocking it might seem useful for sleep, Dr. Allen warns that medications like doxylamine don’t promote the deep, restorative sleep the brain needs.
“They reduce REM sleep, which is crucial for emotional balance and memory processing.”
Older adults are particularly at risk when it comes to doxylamine and similar medications.
“Age-related changes in the brain reduce cognitive reserve,” says Dr. Kamboj.
“That means seniors are more susceptible to side effects like confusion, falls, and worsening memory.”
Dr. Nguyen agrees: “It’s very risky for elderly patients to take high doses of doxylamine for long periods. The damage may not be immediate, but it can add up over time.”
Despite the risks, doxylamine succinate isn’t inherently harmful when used properly and sparingly.
“It can be safe when used at the lowest effective dose and for the shortest possible duration,” says Dr. Deanna McDanel, a clinical pharmacy specialist.
In fact, doxylamine is often used in combination with vitamin B6 to treat nausea during pregnancy, where it’s generally considered safe.
But for the general population—especially older adults—routine use should be avoided unless advised by a healthcare provider.
If you’re currently using medications that contain doxylamine or similar ingredients, it’s worth considering alternatives with fewer long-term risks.
Doxylamine succinate may seem like a harmless option when you’re desperate for sleep or allergy relief—but over time, especially in older adults, it could come at a cost to your brain health.
If you’ve been using these medications regularly, talk to your doctor about safer alternatives and strategies that support better sleep and well-being without long-term risk.
Read next: What you need to know about "gas station heroin"—the illegal drug hiding in plain sight
Have you ever used medications like Unisom or Benadryl? Did you notice side effects or find a better alternative? Share your experiences in the comments—we’d love to hear from you and learn what’s worked for you.
Most of us assume that if a medication is sold over the counter, it must be safe.
After all, you can pick it up at any pharmacy or grocery store—no prescription needed.
But doctors are now warning that some of these everyday remedies may not be as harmless as they seem, especially when used frequently or for long periods of time.
If you regularly rely on sleep aids or allergy medications, this is one warning you’ll want to pay attention to.
A specific ingredient found in many popular OTC products may be putting your brain health in jeopardy.
Some common over-the-counter sleep and allergy medications may carry hidden risks—especially for brain health as we age. Image Source: Pexels / Photo By: Kaboompics.com.
What’s the ingredient raising concern?
The ingredient is doxylamine succinate, a first-generation antihistamine found in common sleep aids like Unisom and some allergy medications, including diphenhydramine (better known as Benadryl) and hydroxyzine (Vistaril or Atarax).
While these medications can provide short-term relief, medical experts caution that regular or long-term use may come with serious side effects for your brain.
“Doxylamine succinate, a first-generation antihistamine, can have negative impacts on brain health—especially when patients use high doses frequently or over extended periods,” says Dr. Duyen Nguyen, an allergist with Memorial Hermann.
Short-term side effects like confusion, drowsiness, and dizziness are fairly well-known.
But what worries doctors more is the growing evidence linking long-term use to memory problems, cognitive decline, and even increased risk of dementia—particularly in older adults.
Dr. Sanjay Kamboj, a specialist in allergy and immunology, adds: “While occasional use of doxylamine in healthy adults is typically safe, frequent use can lead to neurodegenerative changes or worsen existing dementia risk factors.”
The keyword here is occasional—not nightly, not every allergy season.
Also read: Over 14,000 cold and flu products recalled—are you at risk?
What the science tells us
The concern around doxylamine succinate isn’t just theoretical.
A landmark 2015 study published in JAMA Internal Medicine showed that people with higher cumulative use of anticholinergic medications—which includes doxylamine—had a significantly increased risk of developing dementia.
“These medications block acetylcholine, a neurotransmitter critical for memory, learning, and focus,” explains Dr. Chris Allen, a sleep medicine physician.
“Over time, this disruption can lead to structural and functional changes in the brain.”
Acetylcholine also promotes alertness and wakefulness.
So while blocking it might seem useful for sleep, Dr. Allen warns that medications like doxylamine don’t promote the deep, restorative sleep the brain needs.
“They reduce REM sleep, which is crucial for emotional balance and memory processing.”
Also read: 7 fever myths you still believe—doctors set the record straight!
Why seniors are more vulnerable
Older adults are particularly at risk when it comes to doxylamine and similar medications.
“Age-related changes in the brain reduce cognitive reserve,” says Dr. Kamboj.
“That means seniors are more susceptible to side effects like confusion, falls, and worsening memory.”
Dr. Nguyen agrees: “It’s very risky for elderly patients to take high doses of doxylamine for long periods. The damage may not be immediate, but it can add up over time.”
When is doxylamine safe to use?
Despite the risks, doxylamine succinate isn’t inherently harmful when used properly and sparingly.
“It can be safe when used at the lowest effective dose and for the shortest possible duration,” says Dr. Deanna McDanel, a clinical pharmacy specialist.
In fact, doxylamine is often used in combination with vitamin B6 to treat nausea during pregnancy, where it’s generally considered safe.
But for the general population—especially older adults—routine use should be avoided unless advised by a healthcare provider.
Also read: Are these common medications putting you at risk? See the FDA’s latest warning
Safer options for allergies and sleep
If you’re currently using medications that contain doxylamine or similar ingredients, it’s worth considering alternatives with fewer long-term risks.
For Allergies:
- Second-generation antihistamines such as loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra) are less likely to affect the brain and typically have fewer side effects.
- Nasal steroid sprays like fluticasone (Flonase) can provide targeted relief without sedation.
- Allergy shots (immunotherapy) may offer a long-term solution for moderate to severe allergies.
- Prescription options like montelukast (Singulair) can also help, depending on your symptoms.
For Sleep:
- Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the most effective long-term solution for chronic sleep problems.
- Sleep hygiene improvements—like going to bed at the same time each night, avoiding screens before bedtime, and creating a cool, quiet sleep environment—can make a noticeable difference.
- Natural supplements such as melatonin or magnesium may help some people, but it’s important to talk with your doctor first to ensure safety and effectiveness.
Doxylamine succinate may seem like a harmless option when you’re desperate for sleep or allergy relief—but over time, especially in older adults, it could come at a cost to your brain health.
If you’ve been using these medications regularly, talk to your doctor about safer alternatives and strategies that support better sleep and well-being without long-term risk.
Read next: What you need to know about "gas station heroin"—the illegal drug hiding in plain sight
Have you ever used medications like Unisom or Benadryl? Did you notice side effects or find a better alternative? Share your experiences in the comments—we’d love to hear from you and learn what’s worked for you.
