Does Benadryl help with or cause anxiety?

One of the most common side effects with Benadryl is drowsiness, but in some people it can have the opposite effect, known as paradoxical excitation. Instead of feeling sleepy, you may feel excited, agitated or have insomnia (trouble sleeping), which might make your anxiety symptoms worse. Paradoxical excitation may be more common in younger children.

If Benadryl (generic name: diphenhydramine) has been prescribed or recommended by your healthcare provider, contact them first before you stop treatment.

Can I treat anxiety with Benadryl?

Benadryl is not typically used to treat anxiety, as long-term use can be associated with side effects, especially in the elderly. In addition to drowsiness or confusion, long-term use of drugs with anticholinergic properties, like Benadryl, may increase the risk for memory loss or dementia in older patients and cause common side effects like confusion, dry mouth, and constipation.

Learn more about using drugs with anticholinergic properties in older people by reviewing Anticholinergic Drugs to Avoid in the Elderly.

Benadryl, a sedating antihistamine, is not approved by the FDA to treat anxiety. You should only take it for this use under your doctor's directions.

Hydroxyzine (brand name example: Vistaril) is the only prescription antihistamine approved to treat anxiety and tension. For longer-term anxiety, medicines such as selective serotonin reuptake inhibitors (SSRIs) antidepressants, such as sertraline (Zoloft) or paroxetine (Paxil) may be other options.

Why does Benadryl cause paradoxical excitation?

It’s not known exactly why paradoxical excitation with Benadryl occurs. It is thought that it may have to do with the way the drug is metabolized (broken down) in the body for excretion, as described in one small case report.

• Benadryl is metabolized in the liver by an enzyme known as CYP2D6. It also appears to inhibit (or blocks) the use of this enzyme.
• Some people have extra copies of the 2D6 gene and are called "ultrarapid metabolizers". These people can quickly break down CYP2D6 substrates like diphenhydramine, the active ingredient in Benadryl.
• The researchers suggested that in people who are CYP2D6 ultrarapid metabolizers, a compound may be created that leads to excitation instead of the typical drowsiness, but they also say more research is needed to explore this idea.

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What are the symptoms of paradoxical excitation?

Some of the common central nervous system (CNS) side effects that may be related to paradoxical excitation with Benadryl include:

• Agitation / Excitation
• Anxiety
• Insomnia (trouble sleeping)
• Irritability
• Restlessness
• Tremors (the jitters)

Paradoxical excitation may be more common in young children. If you notice these symptoms after taking Benadryl, contact your doctor, who may recommend an alternative, if needed. The side effects due to diphenhydramine should clear up in a day or two once the medication is stopped. In older patients it may take up to 3 days for the drug to be fully eliminated.

You should not use Benadryl to make a child sleepy or give this medication to a child younger than 2 years of age. Always ask your doctor before giving any cough or cold medicine to a child. Death can occur from the misuse of cough and cold over-the-counter (OTC) medicines in very young children.

To review more information about this medicine, see Does Benadryl make you sleepy?

Does anxiety occur if I take too much Benadryl?

Paradoxical excitation can occur even with normal doses of Benadryl, but taking too much Benadryl can be dangerous or even deadly. In children, an antihistamine overdose may cause hallucinations, convulsions (seizures), or death.

Symptoms of an overdose may include:

• Vomiting
• Confusion
• Extreme drowsiness
• Ringing in the ears
• Dry mouth
• Dry eyes
• Dilated pupils
• Limited urination
• Flushing
• Rapid heartbeat
• Seizures
• Tremors or shaking
• Agitation
• Hallucinations

In the event of an overdose of diphenhydramine (Benadryl), call for emergency medical help right away (dial 911 in the US) or contact the Poison Control Helpline at 1-800-222-1222.

This is not all the information you need to know about Benadryl (diphenhydramine) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information or Drug Facts Label discuss this information and any questions you have with your doctor, pharmacist or other health care provider.

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