A Case of Massive Diphenhydramine Abuse and Withdrawal From Use of the Drug

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Abstract
To the Editor.— Antihistamines are the major components of most over-the-counter preparations promoted as daytime sedatives and sleep aids.1 Self-medication with these preparations is common, although tolerance develops quickly.1 Diphenhydramine hydrochloride, a histamine antagonist with both sedative and anticholinergic effects, is one agent found in some nonprescription soporifics. We wish to report a case of protracted massive diphenhydramine intake in a patient using an over-the-counter medication. Report of a Case.— A 34-year-old man with chronic residual schizophrenia was referred to our hospital for gradual reduction of diphenhydramine use. The patient had initiated use of the nonprescription medication Sominex 2 (diphenhydramine hydrochloride, 25 mg per tablet) six months prior to admission to assist with initial insomnia. He noted resultant sedation and mild euphoria and increased the dosage over ensuing months. Initial anticholinergic effects such as dry mouth and urinary hesitancy abated with continued use. At the time of admission,

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