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In Search of The Perfect Sleep Aid

 For many years, modern medicine has been searching for the perfect sleeping pills. Sleeping pills are a special topic in medicine because they have a lot to do with addiction medicine. Of course, not every sleeping pill can cause addiction, but lighter sleeping pills such as valerian tablets, doxylamine succinate (contained in Schlafsterne), melatonin (or Circadin) have short and insufficient effects.


Benzodiazepines, on the other hand, relieve anxiety, which often leads to sleep disorders and are often used by GPs as sleeping pills, although this is not correct. Antidepressants such as mirtazapine are more often used as sleeping pills, but patients often complain of fatigue and drowsiness after their use, which is incompatible with driving, for example.


Z-drugs are the 3rd choice of sleep medicine, they have a long and sufficient effect, but can be very addictive. There are patients who struggle for years with addiction to zolpidem, or zopiclone. Many GPs give up in this fight and prescribe these drugs simply because the patients are already addicted.


Benzodiazepines and Z-drugs have a clear withdrawal reaction even when used briefly.


But we are not giving up.



It has long been known that H1 inhibitors of first (such as clemastine) and second generation (such as cetirizine), which are used as anti-allergic agents without hesitation, have a strong drowsiness effect and even severe sleepiness as a side effect. This drowsiness can last up to 12 hours (perfect nap, right?).


Can we use side effects as the main effect? - Why not? The only “downside” is that we are also treating an allergy predisposition in this case.


The only side effect of antihistamines is mild dry mouth, which is temporary. Antihistamines can also be used without hesitation when withdrawal effects of benzodiazepines occur.


Antihistamines are inexpensive.


Of course, the question is who will do the clinical trial and give us the final answer. 


Translated with DeepL.com (free version)

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