Developed in the 1940s, Benadryl is one of the leading over-the-counter drugs commonly used as an antihistamine for allergies and colds. In recent years, however, it has gained attention for off-label use in managing anxiety due to its sedative effects. We critically assess the implications of using Benadryl for anxiety, considering its pharmacological properties and the risks associated with self-medication, to provide a nuanced understanding of its effects and limitations in this unapproved application.
Benadryl: Composition and Pharmacological Properties
At first, it may seem overly technical to begin a discussion of Benadryl’s use for anxiety with a discussion of the chemical and pharmacological properties of the drug. But understanding the basics about how the drug works is key to understanding its appropriateness for managing anxiety.
Benadryl, known scientifically as diphenhydramine, is a first-generation antihistamine.[1] Histamines provoke an inflammatory response in the body, and benadryl works to reduce cold symptoms by blocking histamine receptors in the brain. Benadryl remains a widely used medication for allergies and common cold symptoms and is available over the counter in forms like tablets, capsules, and liquids.
One of the key properties of histamines that not many are aware of, however, is its role in the regulation of the sleep cycle.[2] This characteristic is responsible for its common side effects in Benadryl such as sedation, drowsiness, and impaired cognitive functioning. Some people use this sedative quality to attempt to treat anxiety. But as we will see, this characteristic is not necessarily positive for those with anxiety disorders.
Is The Use of Benadryl in Anxiety Management a Good Idea?
The use of Benadryl in managing anxiety is a topic that warrants careful consideration. Benadryl is primarily an over-the-counter antihistamine for treating allergies, but its sedative properties have led some to use it for anxiety-related sleeplessness. However, its effectiveness and safety in treating anxiety are questionable.
A crucial point to note is that Benadryl is not FDA-approved or is the standard for treating anxiety. This lack of approval is significant because it means there is insufficient evidence to support its safe and effective use in this context.[3] A 2017 study highlighted this by showing that diphenhydramine was less effective for anxiety symptoms compared to other medications like alprazolam and pregabalin.[4]
Benadryl’s sedative effects can offer short-term relief for occasional insomnia due to anxiety, but these effects do not last with regular use. This limited benefit is overshadowed by the risks associated with long-term or frequent use, including increased dementia risk in older adults.[5]
While the American Academy of Child and Adolescent Psychiatry suggests that Benadryl might help treat anxiety in children and adolescents in the short term, these benefits are not without risks.[6] Daytime drowsiness, lack of effectiveness for severe anxiety, and potential side effects raise safety concerns, especially with long-term use.[7] While Benadryl may provide temporary relief from anxiety symptoms due to its sedative effects, its use as an anxiety treatment is not recommended. Consulting a doctor for an accurate diagnosis and safe treatment options is crucial before considering self-medication with diphenhydramine for anxiety.
The Role of Antihistamines in Managing Anxiety Symptoms
Antihistamines, commonly used for allergy relief, have recently garnered attention for their potential in managing anxiety symptoms. Research indicates that certain antihistamines, such as hydroxyzine, show promise in treating short-term anxiety disorders, primarily due to their sedative effects.[8][9] However, it’s important to note that antihistamines are not universally recognized as primary treatments for anxiety disorders, especially those lasting over 12 months. Their role is more aligned with temporary or adjunctive solutions, offering short-term relief but not addressing the underlying causes of anxiety disorders.
Interestingly, a randomized controlled trial involving 92 patients treated for chronic pruritus with various antihistamines revealed nuanced effects. Cetirizine and hydroxyzine were associated with higher depression, anxiety, and fatigue scores, while other antihistamines like pheniramine and rupatadine improved sleep quality but increased daytime sleepiness.[10]
Antihistamines may not be the best long-term solution due to these risks and their inability to address the root causes of anxiety. Instead, comprehensive treatment plans including therapies like cognitive-behavioral therapy, lifestyle changes, and targeted medication prescribed by a doctor are recommended for lasting relief from anxiety disorders.
Final Thoughts: Can Benadryl Help With Anxiety?
The treatment of anxiety disorders requires a comprehensive, evidence-based approach that includes psychotherapies and pharmacological treatments under the guidance of a medical professional. It’s crucial to avoid using non-prescription medications due to potential risks and side effects. The choice of treatment should be tailored to each individual, considering the type of anxiety disorder, patient preference, side effect profiles, and the risk of abuse with certain medications. Always consult a healthcare professional for advice and supervision in treatment plans.
[2] Arousal effect of orexin A depends on activation of
the histaminergic system – Huang et. al 2002
[3] Medications – Anxiety and Depression Association of America
[4] Pharmacodynamic response profiles of anxiolytic and sedative drugs – Chen et al. 2017
[5] Cumulative Use of Strong Anticholinergic Medications and Incident Dementia – Gray et al. 2015
[6] Anxiety Disorders: Parents’ Medication Guide – American Academy of Child and Adolescent Psychiatry
[7] Benadryl – Uses, Side Effects, and More – Web MD
[8] Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options – Garakani et al., 2020
[9] Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a 3-month double-blind study – Llorca et al. 2002
[10] Assessment of the effects of antihistamine drugs on mood, sleep quality, sleepiness, and dream anxiety – Guzel Ozdemir et al. 2014
