Misleading tricyclic antidepressant findings in cases of diphenhydramine overdose: analysis of two instances and a review of existing literature - Scorecard - MDSpire
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Misleading tricyclic antidepressant findings in cases of diphenhydramine overdose: analysis of two instances and a review of existing literature
Clinical Scorecard: Misleading tricyclic antidepressant findings in cases of diphenhydramine overdose: analysis of two instances and a review of existing literature
At a Glance
Category
Detail
Condition
Key Mechanisms
Antihistamine and antimuscarinic effects leading to sedation, tachycardia, hypertension, fever, vomiting, constipation, delirium, and seizures.
Target Population
Care Setting
Key Highlights
Diphenhydramine is one of the most frequently overdosed OTC medications in Japan.
Urine drug screening kits do not include diphenhydramine as a target analyte.
False-positive results for tricyclic antidepressants can occur with diphenhydramine overdose.
Two cases of diphenhydramine overdose presented with altered consciousness and seizures.
Supportive treatment and monitoring are critical in managing diphenhydramine overdose.
Psychiatric evaluation is essential post-overdose.
Guideline-Based Recommendations
Diagnosis
Management
Provide supportive care and monitor vital signs.
Administer levetiracetam for seizure prophylaxis if indicated.
Manage tachycardia and hypertension as necessary.
Monitoring & Follow-up
Risks
Patient & Prescribing Data
Supportive care and psychiatric evaluation are essential post-overdose, especially for those with a history of self-harm.
Clinical Best Practices
Conduct thorough history taking to identify potential substance use.
Utilize liquid chromatography–tandem mass spectrometry for accurate drug level assessment.
