Could nasal decongestants be harming your brain?

People often use nasal decongestants to clear stuffy noses, but these drugs can affect the brain when someone takes them for a long time or in high doses. During the cold and allergy season, many people turn to nasal decongestants to help them breathe better. The short-term effects are consistent with brain health, as they can improve breathing and sleep quality. However, chronic nasal decongestants used as over-the-counter (OTC) sympathomimetic drugs are harmful and an independent risk factor for ischemic and hemorrhagic brain stroke. It is a silent, hidden healthcare problem.

Ill effects of using nasal drops

According to Dr. Aravind Badiger, Technical Director BDR Pharmaceuticals, “Most of these medicines have pseudoephedrine or phenylephrine as their main ingredients. They work by making nasal blood vessels smaller, which cuts down on swelling and helps people breathe easier. But they also impact the central nervous system, causing problems like headaches, dizziness, or feeling jittery. Using them for a while can lead to tolerance, meaning you need more to get the same relief, which increases the chance of taking too much. This can make the brain-related issues even worse. From a doctor's point of view, while decongestants help right away, they should tell patients about the dangers of misusing them and suggest safer options for people with brain conditions.”



According to Dr. Manish Chhabria, Senior Consultant, Neurology at Sir H N Reliance Foundation Hospital, Mumbai, “Common sympathomimetic drugs like pseudoephedrine, phenylephrine (oral), xylometazoline, and oxymetazolinin are used in conditions like the common cold, allergic rhinitis, sinusitis, and upper respiratory tract infections.”



One of them and the most presumable mechanism of ischemic stroke is vasoconstriction of cerebral arteries, and of hemorrhagic stroke is hypertensive crisis and vasculitis. Pseudoephedrine use may help some people sleep well, but in some it may cause them to lose sleep, resulting in a 'foggy brain’.

Rarer side effects are mental/mood changes (such as confusion, hallucinations); tremors, seizures, drowsiness, dizziness, blurred vision, and nervousness may occur. The use of corticosteroid nasal spray is also strongly associated with possible neurological and psychiatric side effects.






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