Sleep, A Critical Change in Medicine

In my most recent blog post entitled “Sleep” I discussed my views on sleeping medicines. I preceded this discussion with my usual disclaimer followed by what I take:

‘The taking of various sleeping medications is not restricted to Parkinson’s patients searching for a good night’s rest. I will, in this discussion stick with the rules I set down when I started this blog. I only discuss medications or supplements I take and why. I am not a medical doctor and have not had any medical training.

Here is what I take every night about 30 minutes before I turn off the light.
1. One 50mg tablet of Benadryl
2. One 3mg tablet of melatonin”

Following the posting of this blog, I received two messages from readers of my blog referring to recent research in the long-term usage of Benadryl which suggests increased risk of dementia from regular use of the drug. I was aware of some of this research, but the last results, I had reviewed gave little credence to an earlier study making similar claims.

After reviewing the old and more recent research I have decided to discontinue my use of Benadryl for both allergic relief and as a sleep aid.

Benadryl is an antihistamine and belongs to a class of drugs called “Anticholinergics” and has been prescribed and used for relief from allergies and secondarily, as a sleep aid, for over sixty years. In addition, anticholinergic drugs have long been used in the treatment of Parkinson’s Disease, although carbidopa-levodopa therapy has mostly replaced them.

This concern about anticholinergics is not a new controversy, and if you are curious, there is a very interesting study arguing against the Benadryl/dementia connection, published on May 22, 2013 entitled: “Clinical Misinformation: The Case of Benadryl Causing Dementia” by Natalie Smith, MD and published in Clinical Correlations, the NYU LANGONE ONLINE JOURNAL OF MEDICINE:

http://www.clinicalcorrelations.org/?p=6162

A newer study, published online January 26, 2015, comes to the opposite conclusion is entitled: “Cumulative Use of Strong Anticholinergics and Incident Dementia-A Prospective Cohort Study,” by Shelly Gray, et.al.:

http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091745

or here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358759/

This study argues there is a relationship between the long-term use of anticholinergic medicines like Benedryl and dementia. The result has been a flurry of news reports warning of the dangers of taking drugs like Benedryl on a long-term basis. I have not yet seen an academic analysis of the Shelly-JAMA study that offers up any other conclusions. A couple of excellent discussions of these conclusions are:

http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091745

and

http://www.parkinson.org/Problems-with-Anticholinergic-Drugs-in-Parkinson%27s-Patients

CONCLUSION
So, let me reiterate my conclusion from reading these studies, and many more, I have decided it is not worth the risk, however small, to continue taking Benedryl for either allergy relief or as a sleep aid.