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Considerations regarding antihistamines for sleep in children

Considerations regarding antihistamines for sleep in children
Pros Cons
  • Rapid onset of action and relatively short half-life
  • Caregiver acceptance high
  • Generally well tolerated
  • Widely available
  • Low cost
  • Liquid formulations available
  • Combination formulations advantageous in some situations
  • Mixed empirical evidence of efficacy
  • Adverse reactions include anticholinergic (eg, dry mouth, constipation, urinary retention, blurred vision), paradoxical excitation, residual morning sleepiness ("hangover")
  • Development of tolerance to sedation common
  • Possible interaction with other anticholinergics
Bottom line – Consider for short-term situational and/or occasional use in younger children, especially with comorbid atopic disease.
Courtesy of Judith A Owens, MD, MPH.
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