Grandma
Isnt Crazy, Shes Taking Antihistamines
Benadryl,
a brand name for diphenhydramine hydrochloride, is one of the most common
over-the-counter antihistamines used to address a variety of allergic reactions
ranging from those caused by eating certain foods to insect bites and seasonal
allergies caused by airborne irritants. Due to its sedative effects, Benadryl
has also long been considered a safe method to treat insomnia. Research has
proven, however, that such usage with the elderly -- in fact the use of any
antihistamines with this age group -- can cause serious adverse reactions from
dizziness and low blood pressure to actual episodes of dementia,
hallucinations, and unaccountable aggression. Furthermore, any preexisting
conditions worsened by an over-the-counter antihistamine may make it harder to
obtain a decent long
term care insurance policy.
As early as 2001, researchers (Agostini,
Inouye, and Leo-Summers) published an article in Yale's Archives of Internal
Medicine entitled, "Cognitive and Other Adverse Effects of Diphenhydramine
Use in Hospitalized Older Patients." The list of potential side effects
they identified included:
delirium
orthostasis
central
nervous system depression
paradoxical
excitement
visual
disturbances
tachycardia
dry
mouth
urinary
retention
constipation
decreased
cognitive function
Subsequent
studies added
confusion,
hallucinations,
and
delirium
to
the list, pointing to antihistamines as agents that often cause a vicious
domino effect of symptoms and behavior that prolong hospital stays or lead
individuals to be diagnosed with clinical dementia when none is actually
present. In Alzheimer's patients, the use of diphenhydramine and other
antihistamines for sleep exacerbates daytime confusion and may actually speed
the progression of the Alzheimer's itself.
In
instances where diphenhydramine is being used exclusively to treat insomnia,
particularly in the elderly, non-pharmaceutical remedies like melatonin,
valerian, and passionflower are gaining in popularity. When actual allergies
are present, treatment options become more complicated, but alternative methods
like desensitization protocols (some as simple as eating honey produced by local
bees) can offer the sufferer great relief. These methods have been widely
overlooked by the general public as they are not instant gratification answers
that involve simply popping a pill.
Before
using any over-the-counter or natural product, care should be taken to insure
that no interaction with prescription medication will occur. However, since the
widespread use of Benadryl and other antihistamines, often recommended by
physicians themselves, has continued with the elderly even in the face of solid
evidence contradicting such usage, it is up to family and caregivers to
aggressively oppose the practice in the interest of their elderly loved ones
and charges. This issue is particularly important in the nursing home setting
where patients are often given drugs to make them sleep more for the
convenience of the staff than for their own benefit.