Posted by ed_uk2010 on March 8, 2012, at 0:57:25
In reply to parnate sleep problems: any advice?, posted by g_g_g_unit on March 7, 2012, at 22:48:08
>Also, a lot of pharmacists here warn about use of Doxylamine for more than 2 nights in a row, warning that it's highly addictive. Is there any conceivable logic behind this?
Doxylamine is a sedating antihistamine and anticholinergic, related to diphenhydramine. It is not 'addictive' as such, but tolerance to its sedative effect often develops after a few days of regular use. It is therefore not beneficial as a sleep aid in the long term. The recommended dose should not be exceeded because it only serves to cause adverse effects and does not increase efficacy.
There are not likely to be any major safety issues when using it for longer periods, but it is likely to be worthless after the first week or so. After prolonged use, there is a risk of mild withdrawal symptoms typical of anticholinergics eg. vivid dreams and nausea, sometimes called a 'cholinergic rebound'. Similar symptoms often occur when stopping TCAs such as amitriptyline. Doxylamine does not cause the potentially severe withdrawal symptoms associated with short-acting benzodiazepine hypnotics.
Doxylamine can be a useful PRN, or for a few nights in a row, but the quality of sleep after taking antihistamines is not always good. It cannot be alternated with diphenhydramine to prevent tolerance to the sedative effect because these drugs are closely related. It could (perhaps) be alternated with an unrelated drug eg. doxylamine for three days then temazepam for three days.
poster:ed_uk2010
thread:1012580
URL: http://www.dr-bob.org/babble/20120302/msgs/1012581.html