What Are The Side Effects Of Antihistamines?

October 10, 2023

Antihistamines are usually the first type of medication individuals try when they're treating allergies, as these medications are easier to access and take than more involved treatments like allergy shots and steroids. Antihistamines tend to be effective for mild to moderate allergies. When an individual inhales or touches their allergy trigger, the immune system responds by creating histamines. These chemicals lead to swelling in the nose, runny eyes and nose, and itchiness in the eyes, nose, and mouth. Some individuals also experience an itchy skin rash called hives. By blocking or reducing histamines, antihistamines help stop the symptoms of allergies.

However, it's important to understand the potential risks of antihistamines and how to use them responsibly.

Drowsiness

Drowsiness is one of the most well-known and pronounced side effects of antihistamines. These medications are often printed with a label warning individuals to not to drive a car or do other potentially dangerous activities until they're aware of how they affect them. Not every antihistamine on the market causes drowsiness. Some have specific daytime formulas designed to relieve allergy symptoms without triggering drowsiness. So why do some antihistamines make individuals tired when others don't? The answer lies in how they affect a patient's histamine production. Histamines are the part of the immune response that causes allergy symptoms, and antihistamines block a patient's histamine receptors. The first-generation antihistamines, which are the oldest ones still in use, didn't have any nuance in which histamine receptors they blocked. This caused some problems since histamines are also essential to regulating an individual's sleep-wake cycle. By crossing the blood-brain barrier and disrupting the sleep cycle, these antihistamines make individuals sleepy. Newer antihistamines have been optimized to target allergy-causing receptors without inhibiting sleep-wake ones. Though they may still cause some tiredness, they don't have the same exhaustion levels.

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Dry Mouth And Throat

Antihistamines are just one medication that can lead to dryness in the mouth and throat. Dry mouth isn't often a serious cause for concern, and most cases can be treated at home without any problem. However, individuals might experience issues with eating, talking, tasting food, swallowing, and wearing dentures. It's important to treat mouth dryness as a dry mouth is more susceptible to infections and gum disease. The easiest way to treat dryness is by keeping a beverage nearby and taking small sips throughout the day. The best beverage for this is water, but if individuals don't have water, any liquid is better than none. Individuals can also chew on ice chips and items like sugar-free gum, lollipops, hard candy, soft drinks, and frozen fruit juice. There are over-the-counter saliva substitutes patients can get to help moisten their mouth. Using a humidifier can help prevent dry mouth as well.

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Dizziness

When dizzy, individuals might have trouble keeping their balance, and they might feel like the ground is moving under their feet. They might experience nausea, tinnitus, and stumbling. If the dizziness is serious enough, some patients even fall over or faint. Dizziness can be a side effect of antihistamines, but it can also be caused by the allergies antihistamines are treating. When dizziness is related to the allergies themselves, it's because sinus congestion has become serious enough to affect the inner ear. Antihistamines are more likely to contribute to dizziness if patients take them with certain substances. Because antihistamines increase drowsiness, patients are likely to experience greater drowsiness and dizziness if they take them alongside alcohol, sleeping pills, muscle relaxants, anti-anxiety medications, or antidepressants. If patients are not sure what medications are safe to take with their allergy medication, they should ask their doctor or pharmacist. If every antihistamine they try causes dizziness, patients might need to treat their allergies with something else.

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Nausea And Vomiting

Nausea and vomiting are less common side effects of antihistamines, but they can still sometimes occur. For the most part, individuals will have better results if they switch to other antihistamines, but if that's not the case, they might need to undergo other treatments. Nausea and vomiting don't usually indicate a serious reaction, but patients should still keep an eye on their body. If the illness continues after discontinuing the medication, patients should see their doctor. In addition, patients should get medical help right away if there's blood in their vomit or stool. For some individuals, nausea might come on very soon after taking the antihistamine, but for others, it might not appear until they eat or drink. Individuals can mitigate the nausea-inducing effects of some medications, including antihistamines, by taking them with food. Before doing so, though, they should always ask a pharmacist for advice.

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Issues With Appetite

Some antihistamines can cause loss of appetite, particularly if they also cause an individual to experience nausea and vomiting, a gastrointestinal upset can lead individuals to eat less. However, it's more common for antihistamines to lead to an increase in appetite. In fact, the antihistamine cyproheptadine has been used to help underweight patients gain weight. Researchers have several theories for why this phenomenon occurs. The main one is histamines are integral to the regulation of appetite. Histamines let individuals know when they're full and keep them from getting hungry for certain amounts of time. An antihistamine can counteract the effects of histamines, which can make individuals feel hungrier than usual. Researchers have not yet determined which antihistamines are least likely to cause an increase in appetite, and thus, more studies need to be done regarding the effect different antihistamines have on appetite and weight gain or loss.

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Trouble Urinating

Patients who use antihistamines could experience trouble urinating. These medications relax the bladder, making it retain urine and potentially leading to overflow incontinence. With overflow incontinence, the patient is unable to fully empty their bladder, and it becomes overly full. This could result in an involuntary release of urine, and the patient might not feel any urge to urinate. Urinary leaks could happen during the day, and the patient might wet their bed at night. In addition, the retention of urine could lead to abdominal discomfort or bloating, and patients may experience difficulty starting their urine stream. The urinary stream could be weak or interrupted as well. Urinary retention could increase a patient's risk of urinary tract infections, bladder damage, and kidney damage. Patients who experience urinary symptoms while taking antihistamines should talk to their physician about treatment and the possibility of trying an alternative medication.

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Confusion

Certain types of antihistamines are associated with confusion. This side effect is particularly pronounced in individuals over sixty-five years old. In fact, studies show an antihistamine called diphenhydramine may be associated with memory loss and an increased risk of dementia in this patient group. Seniors show reduced alertness, impairments in episodic memory, and diminished performance on memory tasks while taking diphenhydramine. The risk of confusion and memory issues seems to increase even more when antihistamines are used long-term. For example, a study conducted in senior patients at the University of Washington found that using antihistamines for three years increased the risk of developing dementia by fifty-four percent compared to using antihistamines for three months. Women who are sixty years old or older who take diphenhydramine with lorazepam have an elevated risk of confusion as well. Some health organizations suggest seniors avoid antihistamine use due to the strong likelihood of confusion and memory problems, and many doctors choose to prescribe an alternate drug for these patients. Individuals of all ages who experience confusion while taking an antihistamine should let their doctor know right away as it may be necessary to stop taking the medication.

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Moodiness

Moodiness is a recognized potential side effect of antihistamines. While it is most common in children, adults have also reported this symptom. Loratadine is one of the antihistamines most frequently associated with moodiness as a potential side effect, and moodiness has also been noted while on diphenhydramine. Patients have reported experiencing sudden depression while on this medication, and there have also been reports of paranoia, irritability, aggression, and angry outbursts. For loratadine users, the likelihood of experiencing depression may be increased with the use of the twelve-hour tablets designed for extended-release. Some individuals have reported suicidal thoughts while taking antihistamines. Since these mental health changes could be potentially serious, it is important to mention any mood changes to the prescribing physician urgently, especially in the case of sudden depression and suicidal thoughts. The patient should mention the mental changes began with the antihistamine use. It may be necessary to reduce the antihistamine dose, switch to another antihistamine, or switch to a different category of medicine. Patients who take over-the-counter antihistamines should be aware of the risk for mental health changes, and they should also speak to a doctor if these side effects occur while on the medication.

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Weight Gain

Many types of antihistamines are associated with weight gain. This side effect is so well recognized that some types of antihistamines, including cyproheptadine, are even prescribed to patients who need to gain weight. A 2010 study conducted by Joseph Ratliff found that patients who regularly use prescription antihistamines tend to weigh 4.4 to 9.5 pounds more than individuals in a control group. The same study revealed antihistamine use increased the likelihood a patient would be overweight or obese. Fexofenadine, levocetirizine, and cetirizine are particularly likely to cause weight gain. The drowsiness that could occur with antihistamine use may reduce a patient's physical activity levels, and antihistamines themselves might increase appetite. Patients may wish to monitor their weight while taking antihistamines and make dietary adjustments as needed. If weight gain is concerning, patients may be able to switch to another medication that does not cause this side effect.

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Stomach Pain

Stomach pain is a rare potential side effect of antihistamine use. For some individuals, the pain may be severe. Stomach pain might be related to the urinary retention that can sometimes occur with these medications. In addition, this medicine may lead to constipation, and that could produce stomach pain. Rarely, some patients could experience swelling of the abdomen along with the pain. Patients might want to keep a log of all episodes of stomach pain they experience while on antihistamines. It can be helpful to note any potential food triggers or other issues the patient believes could be contributing to the pain. If stomach pain is severe or continues for more than a few days, patients should see their doctor as soon as possible. It is also important to contact a physician if abdominal pain occurs with burning or pain while urinating. Emergency medical attention is necessary if the abdomen is swollen or if the patient experiences abdominal pain with shortness of breath.

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