Time to say goodbye to Benadryl?

Diphenhydramine, commonly known by the brand name Benadryl, has been sold since 1946. It is an “antihistamine,” meaning it blocks the body’s receptors for the chemical histamine, which is released in response to allergens.

Diphenhydramine works very well to lessen allergy symptoms and is used not only as the sole ingredient in Benadryl but as all or part of the makeup of some 300 mostly over-the-counter medicines.

Diphenhydramine crosses into the brain and makes us drowsy. This “side effect” has caused it to become a widely used sleeping aid. Most OTC sleep aids have diphenhydramine (or doxylamine, a very similar product) as their active ingredient.

The problem with using these older antihistamines for allergy relief is that they are sedating and may make users too drowsy to safely drive or do other tasks requiring attention. They can be especially problematic for older adults and have been linked to falls and auto accidents. Regular use has also been linked to risk of dementia.

They can also be a problem with small children, causing extreme sedation and even coma. Also, oddly enough, in some children they have a paradoxical effect of causing agitation.

For allergy relief three newer antihistamines are available: loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra). These do not get into the brain and are much less likely to be sedating.

How about for sleep?

For very occasional use, diphenhydramine and other older antihistamines are probably OK. Like most sleeping pills, the sleep induced by antihistamines is not natural, with little REM sleep, and the sedation can linger well into the next day. It is not dissimilar to the sleep you get after drinking too much alcohol.

Better choices are melatonin or chamomile, which work immediately, or magnesium, which must be taken regularly and build up in your system. If you find yourself using an antihistamine to sleep more than 2-3 times a month, ask your doctor about alternatives.

So, yes, it is probably time to say adios to diphenhydramine, doxylamine and all the older antihistamines. Be sure to read the labels on OTC products before you buy them.


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Public Health is Not a Partisan Issue

This fall has seen a major outbreak of listeria, a bacterium that can spread via many foods, sickening people in 15 states, with at least 19 hospitalized and four deaths. The outbreak has been tied to packaged pasta meals made by Fresh Realm.

How did we know this and so were able to recall products sold by Fresh Realm? We knew it because of the Foodborne Diseases Active Surveillance Network, commonly called FoodNet. This highly successful program monitors labs in 10 states around the country and actively investigates possible food-borne illnesses.

Despite its critical role in protecting Americans from food-borne illness, the program was drastically curtailed recently. While not closed, staffing was cut and henceforth only two of the prior eight pathogens will be monitored – listeria one of the six cut, along with campylobacter, even though these two bacteria made thousands sick and killed 72 people in 2022.

More recently, draconian cuts were made to the staff of the Communicable Disease Center (CDC), supposedly due to the government shut-down and President Trump’s goal of destroying “Democrat programs.” [Note that about half the staff fired on Friday were reinstated over the weekend!]

When I need to know about the description of a tropical disease that may have been imported to the U.S. or want to follow disease outbreaks anywhere in the world, the first place I look is the CDC-published MMWR (Morbidity and Mortality Weekly Reports). This publication is usually the first to report on new and emerging infectious diseases.

No longer, I guess, as virtually the entire staff of MMWR were fired last Friday.

Despite RFK Jr’s insistence that his top priority was the burden of chronic disease in America, most of the staff guiding our response to chronic disease was also fired, along with those monitoring and responding to the opioid crisis.

The Director of the CDC was fired last month because she refused to be a rubber stamp for ideologues and said she would rely on science rather than politics in her decision-making.

I have met many CDC employees over the years. They are dedicated professionals who could generally be earning more in the private sector but believe in the life-saving mission of the CDC.

We cannot sit idly by while the agencies that keep us healthy are gutted. Write to the White House. Write to your senators and representative. Public health protects Republicans, Democrats and independents. It must not be allowed to fall victim to partisan politics.


Prescription for Bankruptcy. Buy the book on Amazon