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Diphenhydramine abuse and detoxification: a brief review and case report
1 Pharmacy Department, Whitchurch Hospital, Cardiff CF14 7XB,
UK.
* To whom correspondence should be addressed.
Many medicines available over the counter from pharmacies are known to have abuse potential, including diphenhydramine (DPH), an antihistamine with antimuscarinic properties used for the treatment of insomnia. We present a brief review of the literature describing DPH abuse, and report the case of GF, a 56 year old woman who was admitted to an inpatient addictions unit for detoxification from DPH. A literature search revealed five case reports of DPH abuse including a total of six patients, published between 1986 and 2001. All reported cases exhibited features of DSM–IV criteria for substance dependence, and there was an apparent link with antipsychotic usage. GF was treated with antipsychotics, and was using up to thirty 50 mg DPH tablets each day. She described feeling 'good and calm' and 'it stopped the tremors'. GF tolerated a gradual dose reduction schedule, and completed the detoxification programme relatively comfortably. She was discharged from the inpatient detoxification unit as planned, and had not relapsed at six months. The described case report highlights the importance of enquiring about non prescribed medication when taking a drug history. Similarly community pharmacists or GPs should be vigilant to excessive requests for DPH, particularly in patients with a psychotic illness. Key Words: diphenhydramine, drug detoxification, drug abuse
First published on February 28, 2008, doi:10.1177/0269881107083809 |
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