29 Comments
User's avatar
Rachael's avatar

Thank you for this summary!

Julia Y's avatar

Other otc sleep aids (Unisom) contain doxylamine, another first generation & anticholinergic antihistamine. Perhaps an important point to include in that section. Thanks for your work!

malatela's avatar

When I first moved to the UK I was surprised "Benadryl" here was cetirizine.

You can get diphenhydramine but it's sold as a sleep aid, not as an antihistamine. It turns out there's not much reason to use these first generation antihistamines other than specifically for the sedating effects.

People in the US are mostly using it because of brand name recognition. But the newer ones work better and are safer. I stopped buying it.

John Fontaine, Phm's avatar

Common problem for vary OTC products in Canada, likely the US...brand name extension which is quite often misleading, sadly people don't read the actual ingredients. Having practiced for decades I long ago learned to look at the ingredients when selecting the most appropriate & cost effective choice for clients.

JJF Phm 🇨🇦

JB's avatar

interesting! I had to look this up and I see what you are saying about UK Benadryl containing cetirizine or acrivastine in place of diphenhydramine.

Carolina Caterwaul's avatar

Interesting. I've read other anticholinergic meds are bad too.

Bernadette Fitzpatrick's avatar

Watched documentary with Medical Dr. Who strongly associated anti cholingeric drugs with onset of memory loss in older people. Most people take drugs and never check the side effects . As you age ie over 65 yrs you're far more likely to have a stronger reaction to a drug. Drowsiness causes falls and a fall for an elderly person can lead to fractures and of course there's very. real danger if driving as you cannot fully concentrate .

Sandy Murray's avatar

Dr. Gershman, there is a recurring formatting error in this excellent article:

When used appropriately, Benadryl can be helpful for some people. But for certain groups, especially older adults, it’s often not the best choice. Because of these risks, Benadryl appears on the American Geriatrics Society Beers Criteria

EditSign

, a list of medications that adults aged 65 and older

Unbiased Science's avatar

Hi Sandy - Sometimes Substack adds some weird formatting, and it's hard for us to tell what our audience sees. These formatting errors have since been fixed, so thank you for pointing them out!

Shari's avatar

Anyone like me who watched the ravages of vascular dementia devour a parent whose chronic migraines were misdiagnosed for decades as “sinus headaches” or “hay fever”--and who was told by docs to take antihistamines (Triaminicin!) for decades-- has a deep-seated, almost irrational, fear of Benadryl and its ilk. I would not wish my mother's last decade on anyone or any family. I've inherited her migraines, but thankfully not her era of healthcare.

Jason Merchey's avatar

Thank you. I do recommend proofreading first.

Stephen John John Smith's avatar

One time the agents on the case for a slime mold tizzly wick took compazine readings in my dingaling - that's how ai seems to influence my mind. I will certainly try to take as much benadryl as I can.

Robert Mead's avatar

Benadryl is an outdated drug which causes significant side effects even in young people. There are much more acceptable alternatives that are safer and just as effective.

This medication should be removed from the market.

Elizabeth Earl's avatar

Hello, I am assuming hydroxyzine for sleep would pose a similar risk? My husband has severe insomnia and just started taking hydroxyzine but I am concerned about this. He is his late 40s so I’m hoping maybe a short course of the medication can get his sleep back on track, along with other tools.

Dr. Domo's avatar

I’ve heard this so much even in veterinary medicine. I don’t use Benadryl (diphenhydramine) but it’s still the go to for pets when they are having an allergic reaction.

John Fontaine, Phm's avatar

Not commonly known even for young pharmacy students, who frequently ask...

What's the difference between Gravol™ (diMENhydrinate) and Benadryl™ (diphenhydramine)?

Essentially, nothing...ok check their pharmacokinetics, minor... dimenhydrinate is a 1:1 mixture of diphenhydramine & 8-chlorotheophylline {ratio 55/45%} also refer as diphenhydramine teoclate. ‎

Gravol 50 mg = Benadryl 25 mg

Although, I don't have a reference (someone may choose to search) a sdt dose of Benadryl produces ~ impairment of 0.08% blood alcohol...yeap!

Regardless, if not "accurate" taking Benadryl or Gravol & choosing to drive or operate machinery is clearly unwise, dangerous & possibly illegal...DUI

There really is no reason to recommend Benadryl.

JJF Phm 🇨🇦

Bernadette Fitzpatrick's avatar

As regards allergies the advice now is to give your child a wide variety of food and if there's a reaction like itching the food should not be stopped completely . Ive seen this on government health advert . A mild reaction does not warrant stopping a food completely when weaning your child.and the advice is to not exclude foods as has been the case in the past .

Patrice La Belle, M.D.'s avatar

Has there been any studies on the potential developmental effects of anticholinergic antihistamines in children? Does it affect brain development in addition to lost learning due to fatigue?

Jennifer Gershman, PharmD, CPh's avatar

Hi topical use isn't likely to cause issues since it's not absorbed very much into the bloodstream. The effects are more local on the skin.

John Fontaine, Phm's avatar

Topical 'diphenhydramine' is a poor choice given it can cause a hypersensitivity reaction...try 1% hydrocortisone

Linda S's avatar

Topical BENEDRYL?

Jennifer Gershman, PharmD, CPh's avatar

Hi topical use isn't likely to cause issues since it's not absorbed very much into the bloodstream. The effects are more local on the skin.