Benadryl (diphenhydramine) is one of the most potently anti-cholinergic medications available today.
As such it is a common cause of delirium and should NEVER be used to treat any aspect of delirium.
Unfortunately, we still see this medication being used in older patients either for sleep induction or to reduce agitation.
It is soporific, but its effects last well into the next day.
Moreover, in addition to creating or worsening delirium, this medication commonly causes the following adverse effects:
- dry mouth
- urinary retention (men)
- thickened respiratory secretions
- prolonged sedation
- delayed recovery
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Limit use of Benadryl in older patients to treatment of serious allergic reactions where suppressing histamine release is urgent and the patient is significantly symptomatic from the allergic process.
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