People’s Pharmacy: PM pain reliever triggered memory loss

Q. My wife had sleep problems for years, and started taking Tylenol PM every night (for the diphenhydramine). Over time, she began experiencing memory loss, enough that it affected her work and home life. Her family has some incidence of age-related dementia or Alzheimer’s, so this was very worrisome.

After reading one of your columns this year, we connected the dots, and she abandoned the sleep aid. It is about six months later, and she feels that she has nearly entirely recovered her mental acuity. She feels SO much better mentally, and her communication skills have been restored to normal levels. I’m writing to express our thanks.

A. Diphenhydramine (DPH) is a sedating antihistamine that is found in almost all over-the-counter “PM” pain relievers. It also is found in some OTC sleeping pills and allergy drugs like Benadryl.

A recent review of sleep medicines for older adults concluded: “Diphenhydramine should be avoided in the elderly” (Clinical Therapeutics online, Oct. 14, 2016). The authors note: “Grogginess, drowsiness, confusion, and memory loss have been well described with use of diphenhydramine. Community-dwelling older adults were shown to have reduced alertness, diminished memory task performance, and impaired episodic memory with diphenhydramine.”

DPH, like many other drugs, affects brain function through the neurochemical acetylcholine. You can learn about other medications that contribute to confusion and memory loss in our Guide to Drugs and Older People. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (68 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. O-85, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: peoplespharmacy.com.

Q. My husband was diagnosed with cluster headaches in 1999, a few months after receiving a pacemaker. The first eight years, he tried 31 different prescriptions, and nothing worked.

Finally, a doctor prescribed oxygen, and it was such a relief. Until then, he was suffering three headaches a day for months on end. He also lived on Excedrin Migraine, around 10 pills a day. Breathing oxygen provided relief within minutes.

He retired in March of 2015, and Medicare REFUSES to pay for oxygen for headaches. His cluster headaches are back. A neurologist prescribed prednisone, but the effect is only temporary. They will come back, as they always do.

Unfortunately, Social Security does not stretch far enough to afford the oxygen on our own. He will have to go back to Excedrin again. My heart goes out to all who suffer these awful debilitating headaches.

A. Oxygen inhalation is considered a first-line treatment for cluster headaches by the American Headache Society (Headache, July/August 2016). It is outrageous that Medicare does not cover this evidence-based treatment. Your husband’s doctor should appeal this unscientific decision.

In the meantime, your husband should be cautious about consuming so much Excedrin Migraine. The makers of Excedrin Migraine warn people: “Do not take more than 2 caplets in 24 hours unless directed by a doctor.”

Q. Using old-fashioned Listerine for my itchy scalp worked wonders. Thank you for writing about this remedy.

A. The original maker of Listerine used to advertise its product for “infectious dandruff.” While the Food and Drug Administration no longer allows this claim, the ingredients in Listerine do have antifungal activity. Many people report that rinsing the scalp with amber Listerine relieves itching and flaking.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or email them via their website: PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”