{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:20:47Z","timestamp":1791379247348,"version":"4.3.2"},"reference-count":11,"publisher":"MedWorks Media","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychopharmacol Bull"],"abstract":"<jats:p>Background: Diphenhydramine, an over-the-counter antihistamine, is increasingly misused by adolescents for its sedative and hallucinogenic effects. Despite its accessibility and perceived safety, chronic misuse poses serious risks, including neurologic, psychiatric, and gastrointestinal complications, especially in vulnerable youth with preexisting trauma or psychiatric illness. Case: We present a case of a teenage female with a history of traumatic brain injury, major depressive disorder, and restrictive eating disorder who was admitted following a diphenhydramine overdose. Her suicide attempt was preceded by a two-year history of undisclosed daily diphenhydramine misuse, initially for mood regulation and later escalating to dependency. Multisystem symptoms including seizures, disordered eating, and behavioral changes were retrospectively linked to her chronic use. Her TBI and initial seizure also coincided with a period of increased diphenhydramine ingestion, raising concern for misattributed or missed diagnoses. Discussion: This case highlights the diagnostic challenges posed by diphenhydramine misuse in adolescents. Chronic use can mimic or exacerbate psychiatric and neurologic conditions, delay appropriate intervention, and contribute to unnecessary polypharmacy or healthcare utilization. Her improvement with structured psychiatric care and medication discontinuation supports the role of early identification and trauma-informed management in preventing further harm. Conclusion: Diphenhydramine misuse should be considered in adolescents with overlapping psychiatric, neurologic, and gastrointestinal complaints. Routine psychosocial screening and awareness of non-traditional substances of abuse are essential for timely diagnosis and intervention. Psychopharmacology Bulletin. 2026;56(1):131\u2013136.<\/jats:p>","DOI":"10.64719\/pb.15435","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T16:38:16Z","timestamp":1767976696000},"page":"131-136","source":"Crossref","is-referenced-by-count":1,"title":["Multisystem Sequelae of Chronic Diphenhydramine Misuse in an Adolescent: A Case Highlighting the Importance of Comprehensive History-Taking"],"prefix":"10.64719","volume":"56","author":[{"given":"Justin M.","family":"Howe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Vora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54175","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Nemanich A, Liebelt E, Sabbatini AK. Increased rates of diphenhydramine overdose, abuse, and misuse in the United States, 2005\u20132016. Clin Toxicol. 2021;59(11):1002\u20131008. doi: 10.1080\/15563650.2021.1892716.","DOI":"10.1080\/15563650.2021.1892716"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Conca AJ, Worthen DR. Nonprescription drug abuse. J Pharm Pract. 2012;25(1):13\u201321. doi: 10.1177\/0897190011431148.","DOI":"10.1177\/0897190011431148"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Thomas A, Nallur DG, Jones N, Deslandes PN. Diphenhydramine abuse and detoxification: a brief review and case report. Journal of Psychopharmacology. 2009;23(1):101\u2013105. doi: 10.1177\/0269881107083809.","DOI":"10.1177\/0269881107083809"},{"key":"ref4","unstructured":"Sicari V, Patel P, Zabbo CP. Diphenhydramine. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK526010\/"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Schifano F, Chiappini S, Miuli A et al. Focus on over-the-counter drugs\u2019 misuse: a systematic review on antihistamines, cough medicines, and decongestants. Front Psychiatry. 2021;12 doi: 10.3389\/fpsyt.2021.657397.","DOI":"10.3389\/fpsyt.2021.657397"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Darracq MA, Thornton SL. A different challenge with Benadryl: adolescent diphenhydramine ingestions reported to National Poison Database System, 2007\u20132020. Clin Toxicol. 2022;60(7):851\u2013859. doi: 10.1080\/15563650.2022.2051536.","DOI":"10.1080\/15563650.2022.2051536"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Hughes AR, Lin A, Hendrickson RG. Clinical and patient characteristics associated with severe outcome in diphenhydramine toxicity. Clin Toxicol. 2021;59(10):918\u2013925. doi: 10.1080\/15563650.2021.1891244.","DOI":"10.1080\/15563650.2021.1891244"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Camenga DR, Hammer LD. Improving Substance Use Prevention, Assessment, and Treatment Financing to Enhance Equity and Improve Outcomes Among Children, Adolescents, and Young Adults. http:\/\/publications.aap.org\/pediatrics\/article-pdf\/150\/1\/e2022057992\/1560563\/peds_2022057992.pdf.","DOI":"10.1542\/peds.2022-057992"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Kim JH, Ha EK, Han B et al. First-generation antihistamines and seizures in young children. JAMA Netw Open. 2024;7(8):e2429654. doi: 10.1001\/jamanetworkopen.2024.29654.","DOI":"10.1001\/jamanetworkopen.2024.29654"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Hu WW, Fang Q, Xu ZH, Yan HJ, He P. Chronic h1-antihistamine treatment increases seizure susceptibility after withdrawal by impairing glutamine synthetase. CNS Neuroscience & Therapeutics. 2012;18(8):683\u2013690. doi: 10.1111\/j.1755-5949.2012.00356.x.","DOI":"10.1111\/j.1755-5949.2012.00356.x"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Radovanovic D, Meier PJ, Guirguis M, Lorent JP, Kupferschmidt H. Dose-Dependent Toxicity of Diphenhydramine Overdose. 2000;19 www.arnoldpublishers.com\/journals.","DOI":"10.1191\/096032700671040438"}],"container-title":["Psychopharmacology Bulletin"],"original-title":[],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:36:26Z","timestamp":1791315386000},"score":1,"resource":{"primary":{"URL":"https:\/\/medworksmedia.com\/pb-article\/multisystem-sequelae-of-chronic-diphenhydramine-misuse-in-an-adolescent-a-case-highlighting-the-importance-of-comprehensive-history-taking\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,2]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,2]]}},"URL":"https:\/\/doi.org\/10.64719\/pb.15435","relation":{},"ISSN":["2472-2448"],"issn-type":[{"value":"2472-2448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,2]]}}}