Introduction and description
Nasal sprays are used to deliver drugs and as local treatments for conditions affecting the nose itself such as nasal congestion and allergic rhinitis.
The use of nasal sprays is increasing simply because substances can be assimilated extremely quickly and directly through the nose. If we think of the alternatives – the injection for example, a spray seems a simpler option. Seems.
There is a big difference between the effects of a pill ingested or a vaccine delivered by muscular injection and the effects of a nasal spray. Pills have to undergo the rigorous bodily protection systems of the stomach, the gall bladder and its contents, the intestines, and the kidneys and liver. A substance injected is inspected and rigorously fought by the immune system.
But the contents of the nasal spray has direct access to the brain via the olfactory bulb. If the spray is fine enough, the contents will get through. The olfactory bulb is designed to accept very tiny particles – sprays - so that we can smell things. It takes the thing that has been sniffed and then after analysis lets the ‘Will’ know what it thinks it is. In some ways the nose is the one weak link in our armour of formidable defences against pathogens. Parasites have been known to go up the nose and enter the eye because the channels between nose and eye are all interlinked.
In effect whatever is in the nasal spray does not have all the problems of crossing the blood brain barrier, it has direct access to the brain itself. Once in the brain it cannot be fought by the immune system directly. The lymph system bathes the brain in lymph and eventually the pathogen or substance in the brain will be washed out by a combination lymph and the blood circulatory system, but it may take time and during that time the brain is under direct attack. This is why cocaine sniffers sniff – the results are immediate and nothing is ‘wasted’.
Types of nasal sprays
The number of drugs being administered via nasal sprays is increasing. Treatments for pain, migraine, osteoporosis and nausea, hormone replacement therapy, treatment of Alzheimer's disease and Parkinson's disease.
Antihistamines are being delivered by nasal spray.
Influenza vaccine is available in the form of a nasal spray like Live attenuated influenza vaccine.
A number of the nasal sprays used to relieve the symptoms of sinusitis, hay fever, allergic rhinitis and non-allergic (perennial) rhinitis contain corticosteroids. Corticosteroids are immunosuppressants, thus whilst they may [and the operative word here is may] reduce inflammation and histamine production in the nasal passages, they also may enter the brain and thus reduce our natural defences against any pathogens that have lodged there.
I will now use a suitably emotive example, to help you see this may not be the wisest course of action. A parasite [or influenza live virus] enters through your nose and lodges itself there and starts to tunnel its way into the brain.
The immune system fights like crazy to try to beat the parasite or virus and this causes headaches and all the symptoms of an allergy – runny nose, itchiness, sneezing, as the histamine does the trick to open the blood circulatory system so that the defences can get through to the site of attack.
First we use an over the counter nasal spray with anti-histamines in it. This ensures no defences can reach the site. The parasite or virus thinks ‘whoopee’ and tunnels a good deal harder reproducing a bit on the way. The symptoms get worse, so we go to the doctor and the doctor prescribes a nasal spray with corticosteroids in it. These then entirely suppress the immune reaction and the pathogens bloated with your cells and now reaching the level of an army enters your brain. The nose itching stops. You sigh with relief – the doctor’s spray worked. Then a few months later you notice your memory is going and you are diagnosed with dementia, then the headaches suddenly reappear – very bad, and after a scan you are told you have a brain tumour.
Such is the way of the parasite and the virus.
There are such things as salt solutions called saline sprays. Saline sprays should not be medicated. They deliver a mist of saline solution containing sodium chloride - salt.
Three types of saline spray are available including hypertonic (3% sodium chloride), isotonic (0.9% sodium chloride) and hypotonic (0.65% sodium chloride). Isotonic solutions have the same salt concentration as the human body, whereas hypertonic solutions have a higher salt content and hypotonic solutions have a lower salt content.
Saline nasal sprays are commonly used in infants and children to wash out the thick mucus from the nose in case of allergic rhinitis. They are a bit safer than medicated sprays, but it might be more helpful to get rid of the allergen. The mucous in the nose is there to trap the allergen or pathogen, the thickness and stickiness is there because it is a better trap.
It may help the poor little soul breathe better using a saline spray, but it would be a deal more helpful to him or her to get him or her to blow their nose fairly often and for you to search around to find out what you are doing to create this allergy.
It may be helpful to know that badly ventilated houses or houses where the windows are always closed are a haven for fungal spores.
There are also sprays on the market claiming to be ‘natural’ because they contain the extracts from plants as opposed to pharmaceuticals. Aside from the fact that plant extracts are chemicals so the argument that they are ‘natural’ is somewhat dubious, I can see nothing natural about stuffing ginger extract, capsaicin extract or tea-tree oil up your nose. As Wikipedia says
“There is however, no trial-verified evidence that they have a measurable effect on symptoms”.
How you can help yourself
If you have an itchy nose, nasal congestion or are suffering from airborne irritants, pollen and dust, you need a spray bottle similar to the one used in nasal sprays. Now buy yourself a bottle of sterile water – the sort used to top up batteries for example, [distilled water] containing no minerals or anything other than clean pure and pathogen free water.
Put the water in the bottle and very gently irrigate the nose. Don’t try to blow great quantities of water up the nose – the objective is to relieve the irritation and help wash out a few of the pathogens present.
The next step is to peel a raw but mild onion. The objective is to make yourself cry – profusely for some time. A better way of course is to watch a very sad movie over and over again, but this takes more time and has the disadvantage of lowering your spirits when you need your spirits to be up and high and boosting the immune system.
Tears are natural anti-pathogens, the longer you cry the better. Blow your nose gently every so often.
In June 2016, eHealthme ceased to provide the information on which all the data in this section is based. On querying my friends in the USA, it would seem that many of the sites that provided similar information, have done the same. The links we provided to eHealthme also no longer work as this data too has been removed.
As to why all these sites have removed exceptionally important information, my USA helpers said that more and more people are questioning what they are being given – and demanding to know WHY the CAUSE of their illness has not been investigated. It appears that there has been a very heartening increase in the numbers of people who want to be healed – have the cause tackled and not the symptoms. And this is ‘not popular’ with the conventional medical community, who cannot make money from well people.
The statistics collected from eHealthme remain valid for the date they were collected. As such we have left this section as it is – an historical record. Please read this section therefore only as an historical record of the figures that were applicable on the date specified.
One of the difficulties of exploring this area is that most doctors do not follow the cause and effect chain of what may happen as a result of using these sprays. They see the immediate consequences, but do not think through the full chain of consequences. As we will see below one of the side-effects is spiritual experience in the form of unwanted hallucinations. But there are also some very serious consequences of using nasal sprays.
There is a link between cataracts and sorbitol. Too much sorbitol trapped in retinal cells, the cells of the lens, and the Schwann cells that myelinate peripheral nerves can damage these cells, leading to retinopathy, cataracts and peripheral neuropathy, respectively.
We have seen above that there is a very vulnerable organ in the nose called the olfactory bulb. It provides access to the brain and via the various passages linking nose and eye to the eye itself. The olfactory bulb only accepts fine sprays when it transits substances into the brain, and what do we find:
Vicks Sinex 12 Hour Nasal Spray has purified water and sorbitol.
Ectoine spray for treating allergic rhinitis contains sorbital.
Sudafed 0.1% Nasal Spray used, in adults and children aged 12 years and over, contains sorbitol.
Vicks Sinex Soother Nasal Spray Solution for a ‘blocked nose’ contains Sorbitol.
Otrivine Sinusitis Spray contains sorbitol.
Astepro (azelastine hydrochloride) 0.1% nasal spray is an antihistamine .. in an isotonic aqueous solution containing sorbitol
there are more, you need to read the labels.
Some example general side-effects
Using the eHealthme website which records doctor submitted Adverse Drug reports submitted to the FDA and SEDA in the USA only, and summarises them for analysis, we can look at some example actual side effects from a sample of drugs. The most common Sudafed side effects are:
- Headache (281 reports)
- Fatigue (275 reports)
- Insomnia (271 reports)
- Pain (254 reports)
- Drug Ineffective (242 reports)
- Dizziness (237 reports)
- Depression (225 reports)
- Stress And Anxiety (221 reports)
- Chest Pain (210 reports)
Now let us take a look at another drug, the most common Xylometazoline hydrochloride side effects are:
- High Blood Pressure (6 reports)
- Breathing Difficulty (5 reports)
- Cardiac Septal Defect (4 reports)
- Vasoconstriction (4 reports)
- Pulmonary Hypertension (4 reports)
- Adenoiditis (4 reports)
- Headache (3 reports)
- Diplopia (3 reports)
- Throat Irritation (3 reports)
- Multi-organ Failure (3 reports)
Xylometazoline is sold under a number of brand names worldwide, including: According to Drugs.com Otrivin, Triaminic Decongestant. And according to Wikipedia
Antazol, Xylomet Cirovin, Klarigen, Nasolin, Neo-Rinoleina, Novorin, Olynth, Otrinoz, Otriven, Otrivin, Otrivine, Otrix, Rhinoset, Nosikind, Naphthyzinium, Xymelyn, Sinutab Nasal Spray, Snup akut, Xylo-COMOD, Xylolin, Xylovit, Olynth, Xynosine, Xymelin, and Zymelin etc etc
It may be worth noting that it was impossible to find all the hallucinations because of the numerous names.
Loss of sense of smell
Decongestant nasal sprays are available over-the-counter in many countries, including: the United States, New Zealand, Ireland and the UK. They constrict the blood vessels in the lining of the nose. The argument appears to be that by doing this the histamine cannot get through and thus the itchiness will go away. I will not repeat the argument above. The other side-effect they have however is to damage the delicate mucous membranes in the nose. This then causes increased inflammation, and has resulted in people losing their sense of smell – more people than is perhaps commonly realised. As an example and using eHealthme, here are the most common Zicam side effects:
- Smell - Impaired (3,352 reports)
- Ageusia (2,365 reports)
- Hyposmia (298 reports)
- Taste - Impaired (281 reports)
- Nasal Discomfort (231 reports)
- Hypogeusia (204 reports)
- Burning Sensation (165 reports)
- Parosmia (113 reports)
- Multiple Injuries (93 reports)
- Pain (47 reports)
Ageusia is the loss of the sense of taste. Hypogeusia is a reduced ability to taste things. Hyposmia is a reduced ability to smell. Parosmia is the inability of the brain to properly identify an odor’s “natural” smell. Anosmia is the loss of the sense of smell.
This list is not at all atypical. Other names for Zicam are Afrin, Dristan, Nasivin, Nezeril, Nostrilla, Logicin, Vicks Sinex, Visine L.R., SinuFrin, Operil, Dimetapp, oxyspray, Facimin etc etc
Again using eHealthme figures, the statistics for death - the ultimate spiritual experience - are as follows. The figures are only for the USA and do not take into account the rest of the world.
Azelastine and some of its trade names
- On Aug, 20, 2015: 220 people reported to have side effects when taking Azelastine hydrochloride. Among them, 3 people (1.36%) have Death
- On Sep, 7, 2015: 339 people reported to have side effects when taking Astepro. Among them, 2 people (0.59%) have Death
- On Sep, 7, 2015: 2,939 people reported to have side effects when taking Astelin. Among them, 28 people (0.95%) have Death
- On Aug, 24, 2015: 3,935 people reported to have side effects when taking Sudafed. Among them, 41 people (1.04%) have Death
- On Sep, 7, 2015: 236 people reported to have side effects when taking Patanase. Among them, 1 people (0.42%) has Death
- On Aug, 28, 2015: 3,884 people reported to have side effects when taking Nasacort. Among them, 44 people (1.13%) have Death
- On Sep, 7, 2015: 784 people reported to have side effects when taking Nasacort aq. Among them, 4 people (0.51%) have Death
Flunisolide and trade names
- On Aug, 26, 2015: 1,072 people reported to have side effects when taking Aerobid. Among them, 7 people (0.65%) have Death
- On Sep, 7, 2015: 141 people reported to have side effects when taking Nasalide. Among them, 4 people (2.84%) have Death
- On Sep, 7, 2015: 370 people reported to have side effects when taking Nasarel. Among them, 12 people (3.24%) have Death
- On Aug, 29, 2015: 10,726 people reported to have side effects when taking Nasonex. Among them, 161 people (1.50%) have Death
- On Aug, 11, 2015: 1,200 people reported to have side effects when taking Beconase. Among them, 5 people (0.42%) have Death
- On Sep, 7, 2015: 1,343 people reported to have side effects when taking Vancenase. Among them, 11 people (0.82%) have Death.
Budesonide and trade names
- On Aug, 18, 2015: 5,154 people reported to have side effects when taking Budesonide. Among them, 87 people (1.69%) have Death
- On Aug, 22, 2015: 20,889 people reported to have side effects when taking Symbicort. Among them, 391 people (1.87%) have Death
- On Sep, 7, 2015: 4,582 people reported to have side effects when taking Rhinocort. Among them, 23 people (0.50%) have Death
- On Sep, 7, 2015: 13,723 people reported to have side effects when taking Pulmicort. Among them, 183 people (1.33%) have Death
- On Sep, 7, 2015: 1,470 people reported to have side effects when taking Pulmicort respules. Among them, 13 people (0.88%) have Death
- On Sep, 7, 2015: 1,876 people reported to have side effects when taking Pulmicort flexhaler. Among them, 3 people (0.16%) have Death
- On Aug, 26, 2015: 1,763 people reported to have side effects when taking Veramyst. Among them, 11 people (0.62%) have Death
- On Sep, 7, 2015: 10,085 people reported to have side effects when taking Fluticasone propionate. Among them, 116 people (1.15%) have Death
- On Aug, 11, 2015: 16,910 people reported to have side effects when taking Flonase. Among them, 237 people (1.40%) have Death
- On Aug, 14, 2015: 354 people reported to have side effects when taking Omnaris. Among them, 7 people (1.98%) have Death
- On Aug, 26, 2015: 1,615 people reported to have side effects when taking Ketorolac tromethamine. Among them, 22 people (1.36%) have Death
Oxymetazoline under the names
- On Sep, 7, 2015: 4,086 people reported to have side effects when taking Zicam. Among them, 1 people (0.02%) has Death
- On Sep, 7, 2015: 4,456 people reported to have side effects when taking Dimetapp. Among them, 40 people (0.90%) have Death
Adding up the figures for deaths as recorded on the eHealthme website and based on doctor submitted Adverse Drug Reports, the total number of deaths as of early September 2015 was:
this figure covers only the USA and not the rest of the world. It must be a bit of a shock, as you look down from heaven, to realise that not many months before you were trotting into your local chemist for something to relieve a blocked up nose.
How it works
The explanation is given above. The hallucination is either caused by the drug in the brain - and the contents of the spray - or the pathogen that gains a foothold as a result of using spray.
References and further reading
Transl Psychiatry. 2015 Jul 14;5:e602. doi: 10.1038/tp.2015.93. Low-dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized four-way crossover trial with nasal cavity dimension assessment. Quintana DS1, Westlye LT2, Rustan ØG1, Tesli N1, Poppy CL2, Smevik H2, Tesli M1, Røine M3, Mahmoud RA4, Smerud KT3, Djupesland PG5, Andreassen OA1. PMID: 26171983
The following figures for the number of hallucinations come from eHealthme and were derived from the Adverse Drug reports submitted by doctors to SEDA and the FDA. The link takes you to the eHealthme site where all the side-effects can be viewed. The figures were correct as at early September 2015. The product combinations used in nasal sprays has made doing this table somewhat problematical. We have done our best to keep products that have two or more base drugs only under one heading, but the figures as a result may end up confusing. Please take the chart as indicative.
No of hallucinations
Azelastine hydrocholoride other names include Astepro and Astelin
5 + 4 + 31 = 40
Sudafed 0.1% Nasal Spray ++
Oxymetazoline found in Afrin, Dristan, Nasivin, Nezeril, Nostrilla, Logicin, Vicks Sinex, Visine L.R., Zicam, SinuFrin, Operil, Dimetapp, oxyspray, Facimin **
Olopatadine hydrochloride, trade name Patanase
33 + 11 = 44
Aerobid also Flunisolide, Nasalide, Nasarel
39 + 3 = 43
Qnasl and Beconase, alanase, Vancenase
Symbicort, Budesonide, Rhinocort, Pulmocort
94 + 30 + 29 + 82= 153
Fluticasone furoate and Veramyst
Fluticasone propionate trade name Flonase
57 + 119
Triamcinalone trade names include Aristocort, Kenacort, Kenalog, Tricort, Triaderm , Azmacort, Trilone, Volon A, Tristoject, Tricortone and Ratio-Triacomb.
17 + 12 + 1 + 2 + 16 + 16 = 64
Phenylephrine [no figures as a stand-alone drug, only in combinations]
++ eHealthme does not separate out Sudafed as a nasal spray and Sudafed as an oral tablet, but the majority of people appear to be taking this for nasal problems, as such we have placed the full figure for Sudafed as a whole
** Many of these products are only sold over the counter, as such it is somewhat unlikely that people using these would associate an OTC decongestant or anti-rhinitis medication with any hallucinations and go to their doctor. The figures from eHealthme are only doctor submitted. We have kept them in so that the list is complete.
- Adenosine and asthma 005301
- Sedative and anticonvulsant activities of styrax after oral and intranasal administration in mice 020255
- Azelastine, Astepro and Astelin 017679
- Beclometasone 017710
- Beclovent 018031
- Brain injury associated with widely abused amphetamines: neuroinflammation, neurogenesis and blood-brain barrier 023922
- Budenoside, Symbicort and Uceris 017686
- Entocort ec 018950
- Flunisolide and Nasarel 017683
- Fluticasone and Veramyst 017687
- Fluticasone propionate and Flonase 017688
- Intoxication by powdered seeds of horse chestnut (Aesculus hippocastanum) used nasally as snuff - a case report 019054
- Kenalog 019239
- Ketorolac tromethamin 017690
- Nasacort and Triamcinalone 017682
- Nasonex and Mometasone 017684
- Nicorette 018148
- Nicotrol 018152
- Olfactory hallucinations as a manifestation of hidden rhinosinusitis 019881
- Olopatadine Hydrochloride 019801
- Optivar 019813
- Pamine 019828
- Patanase 017681
- Polysporin 019850
- Qnasl and Beconase 017685
- Qvar 40 019990
- Severe psychological disturbance resulting from abuse of nasal decongestants 017692
- Sudafed 017680
- Syntocinon 020164
- Triamcinolone acetonide and Aristocort 017689
- Vanceril 020345