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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