Q. I have been relying on the antihistamine diphenhydramine to get to sleep for more than a decade. But over the last few years, I have found that I am having trouble coming up with simple words when I am talking to someone.

It’s embarrassing when I stumble or substitute a totally inappropriate word for something I cannot remember. I want to give up the PM pain meds with diphenhydramine, but what could I substitute that won’t cause memory problems? I need something to get to sleep!

A. A Viewpoint in JAMA Internal Medicine (Jan. 20, 2026) called for an end to the over-the-counter sale of the oral antihistamine diphenhydramine. That’s partly because the drug interferes with a critical brain neurochemical called acetylcholine. The authors note that this anticholinergic activity can lead to “delirium, dry eyes and mouth, constipation, and urinary retention.”

These physicians go on to state: “In addition, epidemiologic studies have demonstrated an association between long-term use of first-generation antihistamines like diphenhydramine and an increased risk of dementia.”

Some people find that guided meditation or self-hypnosis can help them fall asleep. Others tell us that tart cherry juice, melatonin or magnesium can be helpful. You can read about these and many other approaches in our “eGuide to Getting a Good Night’s Sleep.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com. There are also some herbal remedies that might be helpful.

Q. I suffered for a year with extreme asthma symptoms, not helped by an inhaler like Advair. After a CT scan last month, a pulmonologist prescribed the antibiotic azithromycin. I am supposed to take three pills a week for six months.

At the beginning of week four, I already feel much better and have not needed to use my rescue inhaler. What can you tell me about this antibiotic approach?

A. Asthma is almost always treated with an inhaled corticosteroid such as fluticasone to calm inflammation and a bronchodilator like salmeterol to open airways. That is the combination in Advair.

Sometimes, though, hard-to-treat asthma may be caused in part by an underlying infection. We suspect that is why your pulmonologist ordered a CT scan of your lungs. If he saw something suspicious, that may account for the azithromycin antibiotic.

This antibiotic impacts the lungs in three ways. It can kill bacteria such as Chlamydia pneumoniae that may cause long-term problems in the lungs. Azithromycin also has anti-inflammatory and immune modulating activity (Antibiotics, Oct. 23, 2025).

Your pulmonologist is using the dose of this antibiotic that was employed in the AMAZES trial (Asthma and Macrolides: the Azithromycin Efficacy and Safety Study).

It was reanalyzed in the journal Chest (August 2024). Scientists found the antibiotic helpful for patients “with persistent symptomatic asthma.” Because of possible heart rhythm changes, azithromycin must be carefully supervised by a knowledgeable health care professional.

Q. My doctor wants me to take a statin to lower my LDL cholesterol. I asked AI, “What questions should I ask my doctor?” One answer was to “Ask for a calcium score test.” I did that and was pleased to find my score was a perfect zero! My mind is at ease.

A. An elevated calcium score can help reveal atherosclerosis. Your perfect score probably helped ease your doctor’s concerns. Congratulations on both your good score and using AI intelligently.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”