Sedative-Hypnotic Use of Diphenhydramine in a Rural, Older Adult, Community-Based Cohort: Effects on Cognition

Additive effects of a cholinesterase inhibitor and a histamine inverse agonist on scopolamine deficits in humans

“…Direct neuroanatomical connections between histaminergic and cholinergic nuclei have been maintained evolutionarily from amphibians to humans , suggesting an important coordination of histamine and acetylcholine for optimal brain function. Interestingly, antihistaminergic agents produce cognitive difficulties that overlap with those produced by anticholinergic agents, and as expected, these deficits are more prominent in elderly subjects (Basu et al 2003). However, antihistaminergic agents rarely induce impairments in human memory other than as measured with reaction time, which may be explained by sedative effects (e.g., Curran et al 1998;Van Ruitenbeek et al 2010).…”

Sleep Disturbance in Supportive Care of Cancer: A Review

“…Their side effect profile is burdensome, because they can cause significant cognitive impairment and constipation. [80][81][82] They do not have a role as first-line agents in the treatment of insomnia associated with cancer, but are available over the counter, and use may be initiated by patients or caregivers.…”

Impact of Anticholinergics on the Aging Brain: A Review and Practical Application

“…In nursing homes, more than 30% of elderly residents take more than two anticholinergics, and 5% take more than five [4,38]. In a longitudinal follow-up study of 1627 older, rural community-residing patients, diphenhydramine as a sleeping aid with a strong central anticholinergic effect was reported by 8% of participants and its use has increased from 0.4 to 8% as the cohort aged from a mean of 73.4 to 80.5 years [39]. Furthermore, in randomly selected communitydwelling elders, serum anticholinergic activity was detectable in 90% of the sample; 51% received at least one anticholinergic [5].…”