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Elderly hospital patients who are given
a common type of sedative to help them sleep may be at increased
risk of symptoms of delirium, including disorganized
speech, poor attention level and altered ingredient in a range
of antihistamines and sleep aids, including a number of over-the-counter
medications such as Benadryl and Sominex.
The medication, diphenhydramine, is the
active during their stay.
Overall, patients taking diphenhydramine
were at a 70% increased
risk of symptoms of delirium compared to those
who were not.
Further, when they studied the patients
for individual symptoms of delirium, they found that they
were
- three times more likely to be inattentive
- three times more likely to have altered
consciousness
- more than five times more likely to
show disorganized speech compared with patients not taking
the drug
According to Agostini, older patients
are especially susceptible to the actions of drugs such as
diphenhydramine, which are said to have "anticholinergic"
effects. These drugs block
the actions of an important brain chemical called acetylcholine
and can cause hallucinations, among other symptoms.
Methods other than drugs could be used
to help patients sleep, including providing a quiet environment
for patients during the night and scheduling tests and nursing
checks at the least disruptive times.
Archives
of Internal Medicine 2001;161:2091-2097
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