Benadryl may affect how SSRI antidepressants work
Q: Does diphenhydramine affect how SSRIs work? I’ve been taking Benadryl to sleep because I’m under stress. I’m worried that it might be messing up my Zoloft.
A: You pose a fascinating question. Diphenhydramine (Benadryl) is found in many allergy medicines and over-the-counter sleep aids. Virtually all nighttime (PM) pain relievers contain this sedating antihistamine.
Diphenhydramine may occasionally interact with selective serotonin reuptake inhibitor (SSRI) antidepressants such as sertraline (Zoloft). We found one case report that suggests diphenhydramine affects the neurotransmitter serotonin (Cureus, April 2018). This could lead to a complication called serotonin syndrome.
Too much serotonin can result in elevated heart rate and blood pressure, shivering, tremor, sweating, muscle twitches, agitation, elevated temperature, muscle contractions and, in severe cases, delirium or coma. We would encourage you to reconsider your use of diphenhydramine for sleep.
Q: I have read that high-dose vitamin D did not make a difference when people were admitted to the hospital with COVID-19. Perhaps you should have higher levels of vitamin D circulating in your body when you are first exposed to COVID-19, instead of receiving a massive dose of D after you are already sick and in the hospital.
Higher levels of D at the get-go might prevent the inflammation and immune system overreactions that make
If you’re on an SSRI, taking diphenhydramine for sleep might lead to serotonin syndrome.
COVID-19 so serious for some people.
A: You are referring to a Brazilian study (MedRxiv, Nov. 17, 2020). In it, 240 hospitalized COVID-19 patients got either placebo or 200,000 IU of vitamin D in a single giant dose. There was no difference between the groups with respect to hospital stay, intensive care or ventilator use.
Other research suggests that people with low vitamin D levels in their bodies may be more vulnerable to COVID-19 (Health Security, Dec. 14, 2020). Vitamin D helps calm inflammation. As a result, some scientists hypothesize that people without enough vitamin D are more likely to suffer deadly immune-system hyperreactions if they become infected (Aging Clinical and Experimental Research, Sept. 2, 2020). In other words, they agree with you.
Q: I have taken NSAIDs for pain relief, but they bump up my blood pressure. I had some dental work done, and I took Advil for the throbbing pain. When I checked my blood pressure, it had spiked about 40 points over my usual number.
Is Tylenol less likely
to be a problem? I try to avoid pain meds, but occasionally I have to take something.
A: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve) can raise blood pressure (European Heart Journal, Nov. 21, 2017). Pain can also increase BP.
The makers of Tylenol advertise that their pain reliever “Won’t raise blood pressure the way that Advil, Aleve or Motrin sometimes can.” That sounds reassuring, but you will notice that the commercial does not say acetaminophen (Tylenol) won’t raise blood pressure at all.
Researchers have found that both acetaminophen and NSAIDs “independently increase the risk of hypertension in women” (Hypertension, September 2005). There is also a similar association in men (Archives of Internal Medicine, Feb. 26, 2007).
Occasional use may not pose a problem. Aspirin does not appear to increase blood pressure the way other NSAIDs do.