By Jennifer Beach, LSW, MA, C-SWCM
Norma is a 77-year-old widow who lives in her own home. She has had difficulty sleeping for many years. To help ensure she gets a good night’s rest, she has tried many OTC (over-the-counter medications) including Benadryl. Benadryl’s active ingredient is diphenhydramine, which is an antihistamine used to treat allergic reactions, such as rash, hives, sneezing and runny nose.
Norma found that Benadryl does the trick, helping her to fall and stay asleep for most of the night. The reason is the side effect the antihistamine provides: drowsiness (along with dizziness, dry mouth and throat, confusion and blurred vision). Many people have found these types of “sleep” medications work because of the antihistamine they contain.
Many antihistamines, such as diphenhydramine, are designated as “sedating” antihistamines, which may pose special risks for older adults. Many nighttime pain relief formulas, cough-and-cold remedies, allergy medications, and sleep aids contain sedating antihistamines. These antihistamines may cause drowsiness or fatigue and may worsen some disorders common among older adults, such as closed-angle glaucoma and an enlarged prostate gland. They can also make a person dizzy or unsteady, leading to falls and broken bones.
Antihistamines, particularly at a high dose or in combination with other medications, can sometimes cause blurred vision, light-headedness, dry mouth, difficulty with urination, constipation, and confusion in older adults. Fexofenadine, cetirizine, and loratadine are among the antihistamines considered to be “nonsedating,” and they are less likely to cause drowsiness or other side effects.
Benadryl and many OTC sleep medications (Benadryl, Advil PM, Tylenol PM, Unisom, ZzzQuil etc.) block acetylcholine from working in your body. Acetylcholine is the first discovered and most abundant neurotransmitter in the human body. It acts as a chemical messenger that signals muscle contractions, regulates autonomic functions, and supports critical brain activities like memory, attention span, learning and even emotions.
Older adults may be more susceptible to the possible side effects of antacids, as well. Antacids that contain aluminum are more likely to cause constipation, and antacids that contain magnesium are more likely to cause diarrhea and dehydration.
There have been many studies and different outcomes regarding these types of OTC medications and whether they cause dementia or contribute to it. In one large study of almost 300,000 people, the risk of dementia was significantly higher in those who had taken the highest doses of strong anticholinergic medications. Another large study of adults over 65 years old confirmed these findings. Other studies have shown that the use of an anticholinergic medication can worsen dementia in people who are already having cognitive decline. But not all studies have such clear-cut findings. For example, diphenhydramine (Benadryl) has strong anticholinergic activity. But current research isn’t 100% certain on whether it increases your risk of dementia. A question to consider: Is it worth the potential side effects versus the benefits it may provide?
Although Norma has been sleeping, she has been incontinent more frequently at night. Perhaps her body is not getting the proper signals and sensations her body needs to urinate due to the sedation.
Some common anticholinergic medications include antihistamines, tricyclic antidepressants, medications for irritable bowel syndrome (IBS), and overactive bladder medications.
There may be other areas where OTC medications may be affecting other parts of your brain-body function. Over-the-counter medications are readily available and often perceived as harmless. However, they can pose significant health risks when used improperly or habitually. Many older adults will frequently purchase OTC medications instead of getting a proper consultation and may be at a higher risk of experiencing adverse effects and long-term health complications.
Health Risks Associated with OTC Medication Abuse
- Addiction: Regular use of certain OTC medications, such as pain relievers and cough syrups, can lead to physical and psychological dependence.
- Organ Damage: Misuse of OTC drugs can cause severe damage to vital organs, including the liver and kidneys, leading to chronic health conditions.
- Mental Health Disorders: Abusing medications can result in mental health issues like anxiety, depression and cognitive impairments.
- Masking Serious Conditions: OTC medications may temporarily relieve symptoms but can mask underlying severe health issues that require professional medical attention.
Question to consider are: What is the symptom you or your loved one are taking the OTC medication for? How frequently is it being taken? Is it safe with current medications, vitamins and supplements? Are you or loved one experiencing any side effects? Do any of the OTC contain Acetylcholine? What are the alternative options you may want to try?
It is very important to share all the OTC medications, including vitamins, minerals, herbs and supplements with your medical provider. They all can have potential interactions with medications. This information is crucial and will help the medical provider and/or pharmacist properly evaluate the individual’s entire medication regimen and determine whether an OTC medication may be responsible for certain symptoms.
Original Article: https://www.northeastohiothrive.com/otc-over-the-counter-meds-unexpected-complications/