Benadryl proves itself over and over

Dear Dr. Gott: First of all, I want you to know how much I look forward to your column.

A few months ago, you wrote that Benadryl is a safe sleeping aid for the elderly, yet recent publicity seems to disagree with your conclusion. I await your reply.

Dear Reader: Recent media reports have suggested that diphenhydramine (Benadryl) may not be a suitable sleep aid for the elderly because it can cause hangover, disorganized speech and behavioral disturbances.

While I do not fault these reports, I’d like to point out that 1) Benadryl has a long history of safety, 2) Its side effect profile is minimal, 3) Many of its consequences are no different than those caused by other drugs (such as alcohol), 4) Most of its side effects are trivial, 5) It is the active ingredient in many nonprescription sleep aids (such as Excedrin PM, Nytol, Sominex, Unisom and others), 6) It is not habit-forming and 7) It is available without a prescription.

I am aware of the study in the 2001 Archives of Internal Medicine that purported to show Benadryl is a “horrible choice” because, in the elderly, it can lead to the side effects I mentioned, plus delirium, hallucinations, urinary retention, low blood pressure, drowsiness, bowel problems, irritability and restlessness.

In my experience of over 30 years of medical practice, I have never had any patients who experienced negative side effects from the judicious use of Benadryl as a sleep enhancer. In fact, the drug’s side effects are much less common in the elderly than the complications of other, more powerful sleep medications.

It seems to me that all of us need to examine the risk/benefit ratio of sleeping pills before coming to a conclusion about which brand is appropriate.

In my view, Benadryl is vastly superior to prescription sleeping pills and, based on this opinion, I demand that the researchers I mentioned above provide the name of a nonprescription, nonhabituating substitute for Benadryl.

I’ll keep my readers updated on this intriguing disagreement as it unfolds. In the meantime, you may use diphenhydramine as needed for insomnia.

Obviously some people have a strong reaction to Bendryl and, if they experience undue sedation during the day, they should not use the medicine as a sleep aid.

To give you related information, I am sending you a copy of my Health Report “Sleep/Wake Disorders.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.