Traditional Medicine vs Modern Medicine

The over-the-counter medication diphenhydramine is found in many sleeping pills intended for insomnia treatment. It is the sleep-inducing element in medications such as Simply Sleep, Unisom, Tylenol PM, Advil PM, and Benadryl. Its use does not require a prescription, so it may be a good initial option for the treatment of acute insomnia to help initiate and maintain sleep. However, there is little evidence that diphenhydramine actually improves insomnia, and it may cause sleepiness the day after taking it. Doctors do not recommend routine use of diphenhydramine to treat insomnia. Uses of Diphenhydramine Diphenhydramine has many potential uses. As it does cause sleepiness, it is effective for the short-term treatment of insomnia or acute insomnia. It may help you get to sleep or stay asleep. In addition, it is often administered to relieve allergies or treat allergic reactions, and can be helpful in preventing motion sickness. It is also used to alleviate extrapyramidal symptoms, which may occur as a side effect of other medications. How Does Diphenhydramine Work? Diphenhydramine is part of a class of medications called antihistamines. It works at the level of neurotransmitters, which are the chemical messengers within the brain. It allows the neurotransmitter called histamine to build up in the spaces called synapses that are present between nerve cells. This leads to sedative effects and is accomplished by blocking its uptake into nearby cells. Diphenhydramine works both centrally within the brain as well as in peripheral nerve cells in other parts of the body. It possesses other effects and can suppress cough, nausea, and uncontrolled movements called dyskinesis. Who Should Not Use Diphenhydramine? Children less than 2 years old should not use diphenhydramine. Additionally, caution should be used when this medication is used by children younger than six years old and by the elderly. If you have increased intraocular pressure, such as in glaucoma, you should use diphenhydramine cautiously. Other conditions may also require caution, including individuals who have: hyperthyroidism, heart disease, high blood pressure, asthma, chronic obstructive pulmonary disease, pneumonia, peptic ulcer disease, prostate enlargement, bowel or bladder obstruction. If you have these conditions, you may wish to discuss your risk with your doctor before starting to use the medication. Diphenhydramine has the potential to interact with some other drugs, especially those that affect the brain, so you may wish to review your medications with your doctor or pharmacist before using it.

Diphenhydramine is an antihistamine used for treating allergic reactions. Histamine is released by the body during several types of allergic reactions and--to a lesser extent--during some viral infections, such as the common cold. When histamine binds to its receptors on cells, it stimulates changes within the cells that lead to sneezing, itching, and increased mucus production. Antihistamines compete with histamine for cell receptors; however, when they bind to the receptors they do not stimulate the cells. In addition, they prevent histamine from binding and stimulating the cells. Diphenhydramine also blocks the action of acetylcholine (anticholinergic effect) and is used as a sedative because it causes drowsiness. The FDA originally approved diphenhydramine in 1946. Diphenhydramine is used for the relief of nasal and non-nasal symptoms of various allergic conditions such as seasonal allergic rhinitis. It is also used to alleviate cold symptoms and chronic urticaria (hives). Although antihistamines are the preferred class of drugs in allergic rhinitis, they only reduce symptoms by 40%-60%. Diphenhydramine also is used for allergic reactions involving the eyes (allergic conjunctivitis), to prevent or treat active motion sickness, and for mild cases of Parkinsonism, including drug-induced Parkinsonism. The last two uses (motion sickness and Parkinsonism) are based on the anticholinergic effects of diphenhydramine, and not its antihistamine effects. Diphenhydramine is also used for treating insomnia. DOSING: Diphenhydramine has its maximal effect about one hour after it is taken. When used to combat insomnia, it is prescribed at bedtime. Patients over the age of 60 years are especially sensitive to the sedating and anticholinergic effects of diphenhydramine, and the dose should be reduced. Doses vary depending on formulation. A common regimen for treating adult allergic reaction is 25-50 mg every 4-6 hours not to exceed 300 mg daily. DRUG INTERACTIONS: Diphenhydramine adds to (exaggerates) the sedating effects of alcohol and other drugs than can cause sedation such as the benzodiazepine class of anti-anxiety drugs [for example, diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), alprazolam (Xanax)], the narcotic class of pain medications and its derivatives [for example, oxycodone and acetaminophen (Percocet), and hydrocodone and acetaminophen (Vicodin), guaifenesin with hydromorphone (Dilaudid), Codeine, propoxyphene (Darvon)], the tricyclic class of antidepressants [for example, amitriptyline (Elavil), imipramine (Tofranil), desipramine (Norpramin)], and certain antihypertensive medications [for example, clonidine (Catapres), propranolol (Inderal)]. Diphenhydramine can also intensify the drying effects of other medications with anticholinergic properties [for example, dicyclomine (Bentyl), bethanechol (Urecholine), Probanthine].