Grandma Isn’t Crazy, She’s 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.