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Massive diphenhydramine overdose resulting in death

E P Krenzelok, G M Anderson, M Mirick

    Annals of Emergency Medicine
    |April 1, 1982
    PubMed
    Summary

    A massive diphenhydramine overdose, even if rare, can be fatal. This case details a 7.5g overdose in a teen, leading to seizures, cardiac issues, and death despite medical intervention.

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    Area of Science:

    • Toxicology
    • Emergency Medicine
    • Pediatric Critical Care

    Background:

    • Diphenhydramine overdose can cause anticholinergic symptoms, seizures, and coma.
    • Fatal outcomes from diphenhydramine overdose are uncommon.

    Observation:

    • This report details the largest documented diphenhydramine overdose (7.5 g).
    • The patient was a 14-year-old girl.

    Findings:

    • The patient experienced seizures, cardiac conduction abnormalities, and hemodynamic compromise.
    • Despite life support measures, the overdose resulted in a fatal outcome.

    Implications:

    • Highlights the potential lethality of massive diphenhydramine overdoses, even in adolescents.
    • Underscores the importance of prompt and aggressive management in severe antihistamine toxicity.
    • Suggests a need for increased awareness regarding the risks associated with high-dose diphenhydramine ingestion.

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