“We are seeing either children are taking the medication in an inappropriate amount intentionally or accidentally ingesting it,” said Stephanie Felton, D.O., associate medical director for the emergency department at the medical center in Fort Worth. 

The trend mirrors a similar spike seen at Cook Children’s in 2020. During that year, patients reported getting the idea from TikTok videos claiming users could hallucinate by taking a dozen or more allergy pills. While that trend eventually faded through education and public awareness, a recent resurgence has prompted medical experts to issue a new alert for parents and caregivers.

“These are heartbreaking cases because these are usually normal, healthy, fully-functioning children that can have dire effects because of this choice,” said Dr. Felton.

She adds that these incidents often bring to light underlying issues, including bullying or psychiatric illnesses such as depression or anxiety.

The Power of Open Dialogue

Medical experts say open communication is the first line of defense in preventing an overdose. Dr. Felton acknowledges these can be difficult conversations, however, she emphasizes it can make a potentially life-saving difference.

“Be aware of what they're dealing with, their environments, what they're looking at, what they're watching,” explained Dr. Felton. “Ask them questions, direct questions.” 

Because Benadryl (diphenhydramine) is an over-the-counter medication, it is easily accessible to children and teens. Experts say it is important to communicate that consuming any medication improperly can be detrimental to a person's health in both the short and long term. 

“There is specific per age, per weight, how much you can take of a medication, if you go outside of that you can cause harm to your body,” said Dr. Felton.

Recognizing an overdose

While it may seem trivial because it is an over-the-counter medication, Dr. Felton explains that an overdose can have lifelong effects. This includes heart arrhythmias, electrolyte abnormalities, or urinary retention that can impact the kidneys. Hallucinations can also affect the brain.

Monitor for these symptoms of an overdose:

• Hot but not with a fever
• Pupillary size
• Heart arrhythmias
• Seizures
• Difficulty breathing
• Hallucination

Tips for Poison Prevention: 

Safe Medication Dosing 

• Follow the dosing directions listed on the medication by using the appropriate measuring items, such as a medicine cup or oral syringe.
• Double dosing is NOT twice as effective, and in many instances can cause internal damage.
• Adult medications may be too strong for children and should not be given in half doses. Only give medicine to your child that is intended for children.
• Print the medication schedule to keep the right dosage for your family. 

Safe Storage 

• Many people leave medications on bathroom and kitchen counters as well as bedroom nightstands as a visual reminder to take them. Avoid unintentional injury and store medication up high, locked, and out of reach.
• Hang purses and personal bags up high so children cannot reach prescriptions, vitamins, or other regularly used medications.
• Remember, when visiting friends and family, it is ok to have an open discussion about safe storage. 

Safe Disposal 

• DEA Drug Take Back Day is on April 25th from 10 a.m.-2 p.m.
• Visit a medication drop box at a local pharmacy. For more information on poison prevention, visit www.meddropbox.org.
• The best disposal option is to find a drug take-back location, which may be found in retail, hospital, pharmacies, and/or law enforcement facilities.
• Removing any unused or expired medication in the home can reduce the risk of access. 

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• TikTok Videos Encourage Viewers to Overdose on Benadryl

When deciding about starting a medication as a breastfeeding mother, here are some questions that need to be considered:

1. Has the medication been studied in humans or other mammals?

2. How important is the medication to the mother?  For example, what would happen if the mother did not take the medicine?

Clearly if something is well studied, safe and very important for mom, go for it. If something has been shown to be unsafe and not important, then skip it. In my mind, everything I see is a gray area. If you are not impressed with the helpfulness of this “brilliant” analysis, here are some resources you can use:

1. Your pediatrician or obstetrician. I don’t memorize all the possible drugs, but I do know where to look them up.
2. Infant Risk -Dr. Hale from Texas Tech is one of the national leaders in medication use during pregnancy and while breastfeeding.
3. LactMed –The National Library of Medicine’s Drug and Lactation Database

A Special Consideration: Anti-Depressant and Anti-Anxiety Medications

Because of the relatively small number of breastfeeding mothers on anti-depressants, they are still mostly unstudied. Many have been found to enter the bloodstream at less than 2 percent of the dose (adjusted for the babies weight), but some do reach higher levels (near 10 percent).

Here are some of the ones that enter at higher levels:

• Buproprion
• Fluoxetine
• Lithium
• Venlafaxine
• Diazepam
• Citalopram
• Lamotrigine

Even though we know this, we still don’t know the effects of the medication on the baby is in many ways. The AAP statement highlights the fact that these medications tend to have a build up over time. It is important to note also that baby’s kidneys and liver function (the primary way the we get rid of medications) are not fully mature. Because of this, I evaluate each mother/baby combination by these 3 criteria:

• Benefits of breastfeeding
• Risk of the medication
• Risks of mom’s depression on the child

In summary, I believe we should use caution with all medications with breastfeeding mothers.  If you are breastfeeding, please consult with your pediatrician or obstetrician prior to taking any medication.