Probably the commonest over-the-counter nonspecific antihistamines are also used as sedative diphenhydramine, chlorpheniramine and doxylamine. (often listed in the ingedients in salt form: diphenhydramine HCl, chlorpheniramine maleate, and doxylamine succinate)
Benadryl is Diphenhydramine, but the pink color is part of Benadryl’s brand identity. Other brands or generics seem to prefer a restful blue, though there’s no reason it couldn’t be made in other colors, and it is often sold in liquid form or packaged in capsules. Most people know its effects well. It is the ‘sleeping pill’ most commonly given in hospitals, where patients obviously have other medical issues, because it is considered fairly benign.
Of course, you’ve read the warnings, but you should also know that there are a few mild reversible effects that can occur after extended use. It can cause dry mouth, which may not bother you, but can cause or worsen tooth decay. Chronic users of various illicit drugs often suffer decreased salivation, and without saliva, oral bacteria can have a field day. If you’ve ever wondered what happened to Dick Sargent (the ‘first Darren’ on Bewitched) this was part of his problem. He hurt his back early in the show, got hooked on pain pills, and the last time his fellow cast members saw him (which may have been after the show) amn yof his his teeth were rotten or gone. (Obviously this takes months or years of continuous use to happen) Another unexpected problem can be difficulty or hesitation in urination, which generally reverses in 1-3 days after you stop using it. It should be considered by people with urinary tract infections, prostate problems, and other urinary issues. There are other issues as well, but as I said, most are reversible.
Chlorpheniramine (usually a green or yellow tablet) is generally more sedating, and some find it a more powerful antihistamine. Brompheniramine is a closely related cousin. It is often sold as a sleep aid, at a higher price, just few feet down the aisle from the cheaper allergy-labelled bottles. It’s actually pretty common for a drug labelled as a sleeping aid to be marked up 20-50% over the same drug/dose labeled for allergies. The same dosage, labelled for itching can be more expensive still. Go figure.
Doxylamine (often a small white tablet) is still more sedating, and is often marketed as an over-the-counter ‘ultra’ or extra-strength sleep aid. In fact, I don’t generally see it marketed as an single agent antihistamine at all anymore, so I’m not sure how effective it is. It was still used, the last time I checked, in some popular bedtime liquid cold medications.
Any of these can be combined with alcohol, to enhance the effects. I don’t recommend mixing drugs, but all of the above have been sold over the counter in commercial formulations that combine them with alcohol (that’s a deliberate part of the magic of, say, Nyquil Liquid) - so you get a clear idea how dangerous the drug manufacturers really think mixing antihistamines and alcohol is.
The problem is, of course, is that people tend to ingest more alcohol than they think they do, so self-mixing isn’t quite as benign.
This is not medical advice, because I do not believe that sufficient long-term studies have been done on its chronic use (besides, only an idiot gives medical advice with no medical history and exam), but melatonin has been the sleeping aid of choice among doctors, especially in the ER, and on weird call hours. For all my concerns about long term studies, I have long used it myself. Melatonin is one of the body’s own hormones for drowsiness – which in my mind is actually a primary cause for concern in chronic use, not a mark of automatic safety (You don’t go messing with your hormones). but for occassional use, it should be fine.
I recommend using a small dose - studies show that 200 micrograms (0.2 milligram) is plenty, but for some reason melatonin is usually sold as an unregulated 'health aid" at 15x that dose (3 mg). Personally, I buy the 3 mg tabs and divide them into eighths (I have pharmacist’s gadget that does that, but you can do the same with an X-acto knife and a little practice. For occassional use, it probably won’t matter, but for frequent use, I’d definitely either slice the tablets into eights (ca 375 micrograms) or shell out a little extra for the 200 mcg tablets (paradoxically, the lower dose is often more expensive)
