Diphenhydramine

Key Terms: Allergen, Antihistamine, Extrapyramidal movement disorders.

Definition

Diphenhydramine is an antihistamine used to treat allergies, motion sickness, allergic reactions, insomnia, cough, nausea, and phenothiazine drug-induced abnormal muscle movement.

Purpose

Diphenhydramine is frequently ordered for cancer patients to aid in controlling nausea and itching. It may be given after a blood transfusion to limit allergic reactions to blood products. Because of its sedating properties, diphenhydramine is often used to assist in inducing sleep. It is also used to control nausea, treat the stiffness and tremor of Parkinson's disease, and control symptoms of extrapyramidal neurologic movement disorders (tremors and abnormal involuntary movements of the muscles) caused by some drugs used to treat psychosis or nausea and vomiting). The drug may also be formulated as a syrup and used to relieve a cough caused by minor throat irritation due to a cold or hay fever.

In the context of cancer therapy, diphenhydramine can also be used as a pretreatment to limit the patient's reactions to radiocontrast media or to minimize the toxic side effects of such drugs as docetaxel.

Description

Diphenhydramine is an antihistamine that dries, sedates, and is distributed throughout the body. It is readily absorbed when taken by mouth, with peak action occurring about one hour after ingestion. The effects last from four to six hours. This type of drug seems to compete with histamine for receptor sites after exposure to an allergen. By blocking histamine from attaching to the receptor site, the drug decreases itchiness, a runny nose, hives, and other symptoms of an allergic reaction.

Recommended Dosage

The dose should be adjusted depending on the needs of the patient and their response to the medication. Adults generally take from 25 mg to 50 mg, three to four times daily. For sleep, 50 mg at bedtime is the usual dose. Injectable diphenhydramine, 10 mg to 50 mg, may be administered through a vein or injected deep within a muscle. Some patients may require 100 mg injections. The daily dose should not exceed 400 mg. Patients should not double up on doses if one is missed.

Children weighing more than 20 pounds may take from 12.5 mg to 25 mg, three to four times daily. Children should not consume more than 300 mg in one day. The doctor may calculate a recommended dosage based on the child's weight. Parents should not double up on doses if one is missed.

Lotions or creams with diphenhydramine may be applied to the skin to relieve itching in adults and children older than two. The creams contain 1% or 2% diphenhydramine and may be used on the affected area three to four times per day. Topical diphenhydramine should not be applied to large areas of the body, blistered or oozing skin, sunburn, or lesions caused by poison ivy or chickenpox. Patients should not use topical diphenhydramine with other antihistamine-containing lotions or creams.

Precautions

Patients with angle closure glaucoma, peptic ulcer disease, bowel obstructions, an enlarged prostate, or difficulty urinating due to a blockage in the bladder should not use this medication without a doctor's order and monitoring. This drug should be used with caution in patients with asthma, heart disease, high blood pressure, or an overactive thyroid. Prior to taking this medication, patients with these conditions should discuss this medication with their doctor. Patients should not take diphenhydramine for several days prior to an allergy test. It will interfere with obtaining accurate results.

Elderly patients are especially prone to diphenhydramine's sedating effects. The drug may also cause dizziness and lower blood pressure in this population group. Patients should slowly change position from sitting or lying to standing when taking this medication.

Children also may experience drowsiness. In young children, this drug may produce the opposite effect. Pregnant women and those breast feeding should discuss the use of this and other drugs with their physician prior to use.

Side Effects

Drowsiness commonly occurs after taking diphenhydramine. This effect may be more pronounced if alcohol or another central nervous system depressant, such as a tranquilizer or pain medication, is also ingested. Those taking the drug should refrain from driving or operating machinery or appliances until the medication has worn off. It also may cause dizziness, coordination difficulties, confusion, restlessness, nervousness, difficulty sleeping, blurry or double vision, ringing in the ears, headache, or convulsions.

Stomach distress also is common with diphenhydramine. Patients may develop a poor appetite, nausea, vomiting, diarrhea or constipation. Patients also may experience low blood pressure, palpitations, a rapid or irregular heart beat, an early onset of menstruation, frequent urination, or difficulty urinating, with urine retained in the bladder.

Diphenhydramine may also cause hives, a rash, sensitivity to the sun, and a dry mouth and nose. Thickened lung secretions are common.

A less common but potentially serious side effect of high doses of diphenhydramine is weakening or deterioration of muscle tissue. Patients should be careful not to take higher doses of the drug than their doctor recommends.

Interactions

Alcohol, pain medications, sleeping pills, tranquilizers and antidepressants may make the drowsiness associated with diphenhydramine more severe.

Diphenhydramine's drying effects may be stronger and last longer when taken with an antidepressant called an MAO inhibitor.

Resources

Periodicals

Khosla, U., K. S. Ruel, and D. P. Hunt. "Antihistamine-Induced Rhabdomyolysis." Southern Medical Journal 96 (October 2003): 1023–1026.

Riedl, M. A., and A. M. Casillas. "Adverse Drug Reactions: Types and Treatment Options." American Family Physician 68 (November 1, 2003): 1781–1790.

Vallejo, C. T., M. R. Machiavelli, J. E. Perez, et al. "Docetaxel as Neoadjuvant Chemotherapy in Patients with Advanced Cervical Carcinoma." American Journal of Clinical Oncology 26 (October 2003): 477–482.

Organizations

United States Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857-0001. (888) INFO-FDA (463-6332). .

—Debra Wood, R.N.; Rebecca J. Frey, PhD

Trade name for diphenhydramine hydrochloride, an antihistamine with anticholinergic (drying) and sedative side effects.

Brand names: Aler-Dryl®Aller-Dryl® Allergia-C®Allermax®Altaryl®Banaril™Banophen®Banophen® ElixirBen-TannBenadryl® Benadryl® Allergy Benadryl® ChildrensBenadryl® Childrens Allergy Fastmelt™Benadryl® Itch Relief Benadryl® Itch StoppingBenekraft-25™Calm-Aid®Complete AllergyCompoz® Nighttime Sleep AidDermamycin®Dermarest® Anti-ItchDimine™ 10Dimine™ 50Diphedryl®Diphedryl® Dye Free AllergyDiphen®Diphen® AFDiphen® CoughDiphenadryl®Diphenhist®Diphenhist® CreamDiphenhist® with Zinc AcetateDiphenyl®Diphenylin®DPH®Dytan®Dytan® ChewableElixSure® AllergyEquate® Allergy MedicationEquate® Childrens Allergy ElixirGenahist®Hydramine®Itch Relief®Nervine®Night Time™ Sleep-AidNighttime Sleep AidNu-Med®Nytol® QuickCapsPardryl®PediaCare® Nighttime CoughPhendry®Q-Dryl®Quenalin®Scot-Tussin® Allergy Relief FormulaSiladryl®Siladryl® DASSilphen® CoughSimply Sleep™Sleep IISleep Tab® IISleep Tabs®Sleep®Sleep-ettes®Sleep-Eze® 3Sominex®Somnicaps®Theraflu® Thin Strips™ Multi SymptomTotal Allergy®Triaminic® Cough and Runny NoseTusstat®Twilite®Uni-Hist®Uni-TannUnisom® Sleepgels Maximum StrengthValu-Dryl®Wal-drylWal-dryl Anti-ItchWal-Som Maximum Strength

Chemical formula:

Drug Forms:
• Diphenhydramine oral syrup or elixir (below)
• Diphenhydramine skin cream or solution
• Diphenhydramine Hydrochloride Oral capsule
• Diphenhydramine Hydrochloride Topical cream
• Diphenhydramine Hydrochloride Solution for injection
• Diphenhydramine Hydrochloride Oral tablet
• Diphenhydramine Hydrochloride Elixir
• Diphenhydramine Hydrochloride, Zinc Acetate Topical cream
• Diphenhydramine Citrate Oral disintegrating tablet
• Diphenhydramine Hydrochloride Chewable tablet
• Diphenhydramine Hydrochloride Oral capsule, liquid filled
• Diphenhydramine Hydrochloride Oral capsule, liquid filled [Insomnia]
• Diphenhydramine Hydrochloride Oral solution
• Diphenhydramine Hydrochloride Oral syrup
• Diphenhydramine Hydrochloride Oral tablet [Insomnia]
• Diphenhydramine Hydrochloride Topical gel
• Diphenhydramine Hydrochloride Topical solution
• Diphenhydramine Hydrochloride Topical solution, spray
• Antihistamines Combinations with Analgesics Oral suspension Oral suspension Oral suspension
• Diphenhydramine Hydrochloride, Menthol Topical gel
• Diphenhydramine Hydrochloride, Menthol Topical solution, spray
• Diphenhydramine Tannate Chewable tablet
• Diphenhydramine Tannate Oral suspension
• Diphenhydramine Hydrochloride, Zinc Acetate Topical solution, spray

Español:
• Jarabe o elixir oral de difenhidramina
• Crema o solución de difenhidramina para la piel
• Difenhidramina Clorhidrato, Cápsula oral
• Clorhidrato de difenhidramina, Crema tópica
• Clorhidrato de difenhidramina, Solución para inyección
• Difenhidramina Clorhidrato, Tableta oral
• Clorhidrato de difenhidramina, Elixir
• Clorhidrato de difenhidramina; Acetato de cinc, Crema tópica
• Citrato de difenhidramina, Tableta oral que se desintegra por vía oral
• Clorhidrato de difenhidramina, Tableta masticable
• Difenhidramina Clorhidrato, Cápsula oral llena de líquido
• Clorhidrato de difenhidramina, Cápsula oral llena de líquido [insomio]
• Clorhidrato de difenhidramina, Solución oral
• Clorhidrato de difenhidramina, Jarabe oral
• Clorhidrato de difenhidramina, Tableta oral [Insomnio]
• Clorhidrato de difenhidramina, Gel tópico
• Clorhidrato de difenhidramina, Solución tópica
• Clorhidrato de difenhidramina, Solución tópica, aerosol
• Combinaciones de antihistamínicos con analgésicos, Suspensión oral
• Clorhidrato de difenhidramina; Mentol, Gel tópico
• Clorhidrato de difenhidramina; Mentol, Solución tópica, aerosol
• Tanato de difenhidramina, Tableta masticable
• Tanato de difenhidramina, Suspensión oral
• Clorhidrato de Difenhidramina, Acetato de Cinc, Solución tópica, aerosol

Diphenhydramine oral syrup or elixir

What is diphenhydramine oral syrup or elixir?

DIPHENHYDRAMINE (Banophen®, Benadryl®) is an antihistamine that has many uses. It relieves irritant cough, symptoms of hay fever (allergic rhinitis), hives (rash or itching), and other allergic reactions, motion sickness and vertigo (dizziness and loss of balance), and Parkinson's disease. Generic diphenhydramine oral syrup or elixir are available, with or without a prescription. You can get a sugar-free liquid.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• asthma or chronic obstructive lung disease (COPD)
• glaucoma
• high blood pressure or heart disease
• liver disease
• other chronic illness
• prostate trouble
• pain or difficulty passing urine
• thyroid disease
• ulcers or other stomach problems
• an unusual or allergic reaction to diphenhydramine, other medicines foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Take diphenhydramine oral syrup or elixir by mouth. Follow the directions on the prescription label. Use a specially marked spoon or container to measure your medicine. Ask your pharmacist if you do not have one; household spoons are not always accurate. Take diphenhydramine with food or milk if it upsets your stomach.
Take your doses at regular intervals. Do not take your medicine more often than directed.

If you are taking diphenhydramine to stop you from getting car (or travel) sick, take the first dose 30 to 60 minutes before you leave.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What drug(s) may interact with diphenhydramine?

• alcohol
• barbiturate medicines for inducing sleep or treating seizures (convulsions)
• doxercalciferol
• medicines for anxiety or sleeping problems, such as diazepam or temazepam
• medicines for hay fever and other allergies
• medicines for mental depression
• medicines for mental problems and psychotic disturbances
• medicines for movement abnormalities as in Parkinson's disease, or for gastrointestinal problems
• thyrotropin-releasing hormone

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking diphenhydramine?

Tell your prescriber or health care professional if your symptoms do not improve in 1 or 2 days.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how diphenhydramine affects you. To reduce the risk of dizzy or fainting spells, do not stand or sit up quickly, especially if you are an older patient. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.

Diphenhydramine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your ophthalmologist if the problem does not go away or is severe.

What side effects may I notice from taking diphenhydramine?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• agitation, nervousness, excitability, not able to sleep (these are more likely in children)
• blurred vision
• dizziness or fainting spells
• irregular heartbeat, palpitations, or chest pain
• muscle or facial twitches
• pain or difficulty passing urine
• seizures (convulsions)
Call your prescriber or health care professional as soon as you can if you get any of these.

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• drowsiness, dizziness
• dry mouth
• headache
• loss of appetite
• stomach upset, nausea, vomiting, constipation or diarrhea

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature, between 15 and 30 degrees C (59 and 86 degrees F); do not freeze. Protect from light and moisture. Keep container tightly closed. Throw away any unused medicine after the expiration date.

Last updated: 10/22/2003 2:13:00 PM

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

An antihistamine used as the hydrochloride in treatment of allergic disorders and also for its sedative, antiemetic, antitussive, local anesthetic, and anticholinergic effects. Well known as Benadryl.

Diphenhydramine

Systematic (IUPAC) name
2-(diphenylmethoxy)-N,N-dimethylethanamine
Identifiers
CAS number	58-73-1
ATC code	D04AA32 D04AA33, R06AA02
PubChem	3100
DrugBank	APRD00587
ChemSpider	2989
Chemical data
Formula	C17H21NO
Mol. mass	255.355 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	86% bound to plasma protein
Protein binding	98 to 99%
Metabolism	Various cytochrome P450 liver enzymes: CYP2D6 (80%), 3A4 (10%)[1]
Half life	2.4-9.3 hrs[2]
Excretion	94% through the urine, 6% through feces [3]
Therapeutic considerations
Pregnancy cat.	A(AU) B(US)
Legal status	Over-the-counter
Routes	Oral, parenteral (IM), parenteral (IV), topical, suppository
Y(what is this?)  (verify)

Indicated for: Antihistaminic Motion sickness Sedative/Hypnotic Other uses: Halting allergic reactions, controlling extrapyramidal side-effects induced by antipsychotics

Contraindications: Use in neonates and premature infants Use in nursing mothers Use as a local anesthetic Use in people with hypersensitivity to diphenhydramine hydrochloride and other antihistamines of similar chemical structure

Non-medical use/abuse: Used as a deliriant/hallucinogen

Side effects: Severe: Myocardial infarction (Heart Attack), serious ventricular dysrhythmias, coma and death Atypical sensations: Feelings of heaviness, hearing disturbance Cardiovascular: Hypertension in sensitive individuals Ear, nose, and throat: Dryness of the nose and throat, heartburn Endocrinal: Increased or decreased appetite Eye: Dryness of the eyes, redness of the eyes, yellowing of the eyes Gastrointestinal: Constipation, nausea Liver: Hepatotoxicity in extremely large dosages Musculoskeletal: Incoordination, slow muscle response, fasciculations (twitching) Neurological: restlessness, extrapyramidal side-effects, restless-leg syndrome, confusion, clouded thinking, drowsiness, hallucinations, delirium, euphoria, short-term memory loss Psychological: Agitation, anxiety, emotional lability, depression, excitability (especially in children), paranoia Respiratory: Decreased respiration Skin: Photosensitivity, flushing Urogenital and reproductive: Urinary retention, sexual dysfunction, vaginal dryness, decreased libido Miscellaneous:  ?

Diphenhydramine hydrochloride (pronounced /ˌdaɪfɛnˈhaɪdrəmiːn/) is a chemical mainly used as an antihistamine, antiemetic, sedative, and hypnotic. It is produced and marketed under the trade name Benadryl by McNeil-PPC (a division of Johnson & Johnson) in the U.S. and Canada, and Dimedrol in other countries. It is also found in the name-brand products Nytol, Unisom, and Advil PM though some Unisom products contain doxylamine instead. It is available as an over-the-counter (OTC) or prescribed HCI injectable. It may also be used for the treatment of extrapyramidal side effects of typical antipsychotics, such as the tremors that haloperidol can cause. Additionally, injectable diphenhydramine can be used for life threatening reactions (anaphylaxis) to allergens such as bee stings, peanuts, or latex rather than risking the side effects of epinephrine. It is a member of the ethanolamine class of antihistaminergic agents.

Diphenhydramine was one of the first known antihistamines, invented in 1943 by Dr. George Rieveschl, a former professor at the University of Cincinnati.^[4] In 1946, it became the first prescription antihistamine approved by the U.S. Food and Drug Administration (FDA).^[5]

The brand Benadryl is currently trademarked in the United States by Johnson & Johnson; however, many drug store chains and retail outlets sell less-costly generic versions.

Contents 1 Pharmacological action 2 Common use and dosage 3 Side effects 4 Recreational use 5 See also 6 References 6.1 Notes 6.2 Sources 7 External links

Pharmacological action

Diphenhydramine works by blocking the effect of histamine at H₁ receptor sites. This results in effects such as the increase of vascular smooth muscle contraction, thus reducing the redness, hyperthermia and edema that occurs during an inflammatory reaction. In addition, by blocking the H1 receptor on peripheral nociceptors, diphenhydramine decreases their sensitization and consequently reduces itching that is associated with an allergic reaction. This is why diphenhydramine is a popular choice for treatment of the symptoms of allergic rhinitis, hives, motion sickness, and insect bites and stings.

In the 1960s it was found that diphenhydramine inhibits reuptake of the neurotransmitter serotonin. This discovery led to a search for viable antidepressants with similar structures and fewer side effects, culminating in the invention of fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI).^[6][7] A similar search had previously led to the synthesis of the first SSRI zimelidine from brompheniramine, also an antihistamine.

Common use and dosage

As an antihistamine, the recommended dose for adults is 25–50 mg diphenhydramine every 4–6 hours, not to exceed 50-100 mg every 4–6 hours.^[8]

Diphenhydramine is a first-generation antihistamine drug. Despite being one of the oldest antihistamines on the market it is more effective than even some of the latest prescription drugs.^[9] Consequently, it is frequently used when an allergic reaction requires fast, effective reversal of the often dangerous effects of a massive histamine release.

Diphenhydramine has sedative properties and is widely used in nonprescription sleep aids with a maximum recommended dose of 50 mg (as the hydrochloride salt) being mandated by the U.S. FDA. In the United Kingdom, Australia, New Zealand, South Africa, and other countries, a 50-100 mg recommended dose is permitted.

The drug is an ingredient in several products sold as sleep aids, either alone or in combination with other ingredients such as acetaminophen (paracetamol). An example of the latter is Tylenol PM. Examples of products having diphenhydramine as the only active ingredient include Unisom gelcaps (the tablet form contains doxylamine, a different active ingredient), Tylenol Simply Sleep, Nytol, and Sominex (the version sold in the US — that sold in the UK uses promethazine). Both types are also sold as generic or store brands.

There are also topical formulations of diphenhydramine available, including creams, lotions, gels, and sprays. They are used to relieve itching, and have the advantage of causing much less systemic effect (i.e. drowsiness) than oral forms.^{[citation needed]}

Side effects

Like many other first-generation antihistamines, diphenhydramine is a potent anticholinergic agent. This leads to profound drowsiness as a very common side-effect. Diphenhydramine has also been used as an anxiolytic because of these sedating side effects. However, other side effects include possibilities of motor impairment (ataxia), dry mouth and throat, flushed skin, rapid or irregular heartbeat (tachycardia), blurred vision at nearpoint owing to lack of accommodation (cycloplegia), abnormal sensitivity to bright light (photophobia), pupil dilation (mydriasis), urinary retention, constipation, difficulty concentrating, short-term memory loss, visual disturbances, hallucinations, irregular breathing, dizziness, irritability, itchy skin, confusion, decreased body temperature (generally in the hands and/or feet), erectile dysfunction, excitability, and delirium^[10]. Some side effects such as twitching may be delayed until the drowsiness begins to cease and the person is in more of an awakening mode. Diphenhydramine also has local anesthetic properties, and has been used for patients allergic to common local anesthetics like lidocaine.^[11]

The most common cardiac dysrhythmias associated with diphenhydramine overdose are sinus bradycardia, elongated S-T segment interval, and premature ventricular contraction.^{[citation needed]}

Diphenhydramine is similar in its effects to dimenhydrinate, its 8-chlorotheophylline salt, although the latter is approximately 60% the potency in terms of required dosage and is slightly less sedating.

Some patients have an allergic reaction to diphenhydramine in the form of hives.^[12][13]

Since 2002, the US FDA requires special labeling warning against using multiple products that contain diphenhydramine.^[14] Diphenhydramine has been shown to build tolerance against its sedation effectiveness very quickly, with placebo-like results after a third day of common dosage.^[15]

Paradoxical reactions to diphenhydramine are documented, particularly amongst children, and it may cause excitation instead of sedation. ^{[16] [17]}

Because of potential for more severe side effects, diphenhydramine is on the beers list to avoid in the elderly. (See NCQA’s HEDIS Measure: Use of High Risk Medications in the Elderly, http://www.ncqa.org/Portals/0/Newsroom/SOHC/Drugs_Avoided_Elderly.pdf).

Benadryl Itch Stopping Gel is dangerous when swallowed.^[18]

Recreational use

This section needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (October 2008)

Diphenhydramine is used both clinically and/or recreationally in conjunction with opioids to relieve itching and act as an analgesia potentiator.^[19]

It is used recreationally as a hallucinogen, deliriant, depressant, or as a potentiator of alcohol and some opiates.^{[citation needed]}

Diphenhydramine is a moderate CYP2D6 inhibitor, and as a result can cause increases in blood levels of drugs that are CYP2D6 substrates. Diphenhydramine can also have an additive effect with other CNS depressants.^[20] Due to its interaction with a broad array of medications, combining diphenhydramine with other medications without medical supervision could have unanticipated and potentially hazardous results.

Many users report a side effect profile consistent with atropine intoxication.^{[citation needed]} This is due to antagonism of muscarinic acetylcholine receptors in both the central and autonomic nervous system which inhibits various signal transduction pathways.

In the CNS, diphenhydramine readily crosses the blood-brain barrier, exerting effects within the visual and auditory cortex.^{[citation needed]} Other CNS effects occur within the limbic system and hippocampus, causing confusion and temporary amnesia.

Toxicology also manifests in the autonomic nervous system, causing urinary retention, pupil dilation, tachycardia, irregular urination, and dry skin and mucous membranes.

Considerable overdosage can lead to myocardial infarction (heart attack), serious ventricular dysrhythmias, coma and death.^{[citation needed]}

Such a side-effect profile is thought to give ethanolamine-class antihistamines a relatively low abuse liability.

The specific antidote for diphenhydramine poisoning is physostigmine, usually given by IV in hospital.^{[citation needed]}

Diphenhydramine is among the prohibited and controlled substances in the Republic of Zambia ^[21]. Travelers are advised not to bring this drug into the country. Several Americans have been detained by the Zambian Drug Enforcement Commission for possession of Benadryl and other over-the-counter medications containing Diphenhydramine ^[22].

See also

• Akathisia
• Acrivastine
• Cetirizine

References

Notes

1. ^ "Showing Diphenhydramine (DB01075)". DrugBank. http://www.drugbank.ca/drugs/DB01075. Retrieved 5 September 2009. 
2. ^ "Drug information of Benadryl syr from Johnson & Johnson". MIMS Malaysia. http://www.mims.com/Page.aspx?menuid=mng&name=Benadryl+syr&brief=false&CTRY=MY. Retrieved 5 September 2009. 
3. ^ Garnett, WR (1986). "Diphenhydramine". Am Pharm (NS26(2)): 35–40. 
4. ^ Hevesi D (2007-09-29). "George Rieveschl, 91, Allergy Reliever, Dies". The New York Times. http://www.nytimes.com/2007/09/29/business/29rieveschl.html?ref=health. Retrieved 2008-10-14. 
5. ^ Ritchie J (2007-09-24). "UC prof, Benadryl inventor dies". Business Courier of Cincinnati. http://www.bizjournals.com/cincinnati/stories/2007/09/24/daily52.html. Retrieved 2008-10-14. 
6. ^ Domino, Edward F. History of Modern Psychopharmacology: A Personal View With an Emphasis on Antidepressants. Psychosomatic Medicine 61:591-598 (1999).
7. ^ http://meeting.chestjournal.org/cgi/content/abstract/134/4/c4002
8. ^ "Diphenhydramine". Drugs and Human Performance FACT SHEETS. U.S. Department of Transportation. http://www.nhtsa.dot.gov/people/injury/research/job185drugs/diphenhydramine.htm. Retrieved 2008-10-14. 
9. ^ Raphael GD, Angello JT, Wu MM, Druce HM (April 2006). "Efficacy of diphenhydramine vs desloratadine and placebo in patients with moderate-to-severe seasonal allergic rhinitis". Annals of allergy, asthma & immunology 96 (4): 606–14. PMID 16680933. 
10. ^ "Diphenhydramine Side Effects". Drugs.com. http://www.drugs.com/sfx/diphenhydramine-side-effects.html. Retrieved 2009-04-06. 
11. ^ Smith DW, Peterson MR, DeBerard SC (August 1999). "Local anesthesia. Topical application, local infiltration, and field block". Postgraduate medicine 106 (2): 57–60, 64–6. doi:10.3810/pgm.1999.08.650. PMID 10456039. 
12. ^ Heine A (November 1996). "Diphenhydramine: a forgotten allergen?". Contact dermatitis 35 (5): 311–2. doi:10.1111/j.1600-0536.1996.tb02402.x. PMID 9007386. 
13. ^ Coskey RJ (February 1983). "Contact dermatitis caused by diphenhydramine hydrochloride". Journal of the American Academy of Dermatology 8 (2): 204–6. doi:10.1016/S0190-9622(83)70024-1. PMID 6219138. 
14. ^ Food and Drug Administration, HHS (2002). "Labeling of Diphenhydramine-Containing Drug Products for Over-the-Counter Human Use". Federal Register 67 (235): 72555–9. PMID 12474879. http://www.fda.gov/OHRMS/DOCKETS/98fr/120602a.htm. Retrieved 2008-10-14. 
15. ^ Richardson, GS; Roehrs TA; Rosenthal L; Koshorek G; Roth T. (October 2002). "Tolerance to daytime sedative effects of H1 antihistamines.". Journal of Clinical Psychopharmacology 22 (5): 511–5. PMID 12352276. 
16. ^ [1]
17. ^ de Leon J, Nikoloff DM (February 2008). "Paradoxical excitation on diphenhydramine may be associated with being a CYP2D6 ultrarapid metabolizer: three case reports". CNS Spectr 13 (2): 133–5. PMID 18227744. 
18. ^ "[www.consumermedsafety.org/alerts.asp?p=2008_12_AL32 Warning. Do NOT swallow Benadryl Itch Stopping Gel!]]". ConsumerMedSafety. Institute for Safe Medication Practices (ISMP). December 26, 2008. www.consumermedsafety.org/alerts.asp?p=2008_12_AL32. 
19. ^ Carr KD, Hiller JM, Simon EJ (February 1985). "Diphenhydramine potentiates narcotic but not endogenous opioid analgesia". Neuropeptides 5 (4-6): 411–4. doi:10.1016/0143-4179(85)90041-1. PMID 2860599. http://linkinghub.elsevier.com/retrieve/pii/0143-4179(85)90041-1. 
20. ^ "DiphenhydrAMINE: Drug Interactions.". http://www.umm.edu/altmed/drugs/diphenhydramine-043500.htm#Drug%20Interactions. 
21. ^ "The Drug Enforcement Commission ZAMBIA: LIST OF PROHIBITED AND CONTROLLED DRUGS ACCORDING TO CHAPTER 96 OF THE LAWS OF ZAMBIA". http://www.deczambia.gov.zm/listofdrugs.html. 
22. ^ "travel.state.gov: Zambia". http://travel.state.gov/travel/cis_pa_tw/cis/cis_1062.html. 

Sources

• Charlton BG (2005). "Self-management of psychiatric symptoms using over-the-counter (OTC) psychopharmacology: the S-DTM therapeutic model--Self-diagnosis, self-treatment, self-monitoring". Medical hypotheses 65 (5): 823–8. doi:10.1016/j.mehy.2005.07.013. PMID 16111835. http://linkinghub.elsevier.com/retrieve/pii/S0306-9877(05)00369-5. 

• J.A. Lieberman, History of the use of antidepressants in primary care. Primary Care Companion, J. Clinical Psychiatry, 2003; 5 (supplement 7).

External links

• Prescription Information (PDF)
• DiphenhydrAMINE University of Maryland Medical Center - Includes comprehensive dosage recommendations
• Diphenhydramine entry for recreational use at Drugs-Wiki
• Man 'took own life' in courtroom - suicide by Diphenhydramine - BBC News

v • d • e Antipruritics (D04) Antihistamines for topical use Thonzylamine - Mepyramine - Thenalidine - Tripelennamine - Chloropyramine - Promethazine - Tolpropamine - Dimetindene - Clemastine - Bamipine - Isothipendyl - Diphenhydramine - Chlorphenoxamine Anesthetics for topical use Lidocaine - Cinchocaine - Oxybuprocaine - Benzocaine - Quinisocaine - Tetracaine - Pramocaine

v • d • e Deliriants (anticholinergic hallucinogens) Tropanes Atropine • CAR-226,086 • Hyoscyamine • Scopolamine Benzilates Benactyzine • CAR-301,060 • CAR-302,196 • CAR-302,282 • CAR-302,368 • CAR-302,537 • CAR-302,668 • CS-27349 • Ditran • EA-3167 • EA-3443 • EA-3580 • EA-3834 • N-Ethyl-3-piperidyl benzilate • N-Methyl-3-piperidyl benzilate • 3-Quinuclidinyl benzilate • WIN-2299 Antihistamines Benzhydryl compounds (Cyclizine • Dimenhydrinate • Diphenhydramine), Doxylamine • Promethazine Others Benzydamine • Dicyclomine • Biperiden • Trihexyphenidyl

v • d • e Histaminergics Receptor Ligands H1 Agonists: 2-Pyridylethylamine • Betahistine • Histamine • HTMT • UR-AK49 Antagonists: 1st Generation: Alimemazine • Azatadine • Bamipine • Bepotastine • Bromazine • Brompheniramine • Buclizine • Carbinoxamine • Chlorcyclizine • Chloropyramine • Chlorothen • Chlorpheniramine • Chlorphenoxamine • Cinnarizine • Clemastine • Clobenzepam • Clocinizine • Cyclizine • Cyproheptadine • Dacemazine • Deptropine • Dexbrompheniramine • Dexchlorpheniramine • Dimetindene • Diphenhydramine • Diphenylpyraline • Doxylamine • Embramine • Etymemazine • Histapyrrodine • Hydroxyethylpromethazine • Hydroxyzine • Iproheptine • Isopromethazine • Isothipendyl • Meclizine • Mepyramine • Mequitazine • Methafurylene • Methapyrilene • Methdilazine • Moxastine • Niaprazine • Orphenadrine • Oxatomide • Oxomemazine • p-Methyldiphenhydramine • Pheniramine • Phenyltoloxamine • Promethazine • Pyrilamine • Pyrrobutamine • Setastine • Talastine • Thenalidine • Thenyldiamine • Thiazinamium • Thonzylamine • Tolpropamine • Tripelennamine • Triprolidine; 2nd Generation: Acrivastine • Antazoline • Astemizole • Azatadine • Azelastine • Bamipine • Cetirizine • Clemizole • Clobenztropine • Deptropine • Dimebon • Ebastine • Emedastine • Epinastine • Ketotifen • Levocabastine • Loratadine • Mebhydrolin • Mizolastine • Olopatadine • Phenindamine • Pimethixene • Pyrrobutamine • Rupatadine • Terfenadine • Thenalidine • Tritoqualine; 3rd Generation: Desloratadine • Fexofenadine • Levocetirizine; Miscellaneous: Tricyclic Antidepressants (Amitriptyline, Doxepin, Trimipramine, etc) • Tetracyclic Antidepressants (Mianserin, Mirtazapine, etc) • Serotonin Antagonists and Reuptake Inhibitors (Trazodone, Nefazodone) • Typical Antipsychotics (Chlorpromazine, Thioridazine, etc) • Atypical Antipsychotics (Clozapine, Olanzapine, Quetiapine, etc) H2 Agonists: Amthamine • Betazole • Dimaprit • Histamine • HTMT • Impromidine • UR-AK49 Antagonists: Cimetidine • Famotidine • Lafutidine • Metiamide • Niperotidine • Nizatidine • Ranitidine • Roxatidine H3 Agonists: α-Methylhistamine • Cipralisant • Histamine • Imetit • Immepip • Immethridine • Methimepip • Proxyfan Antagonists: A-349,821 • A-423,579 • ABT-239 • Betahistine • Burimamide • Ciproxifan • Clobenpropit • Conessine • GSK-189,254 • Impentamine • Iodophenpropit • JNJ-5,207,852 • MK-0249 • NNC-38-1,049 • SCH-79,687 • Thioperamide • Tiprolisant • VUF-5,681 H4 Agonists: 4-Methylhistamine • Histamine • VUF-8,430 Antagonists: JNJ-7,777,120 • Thioperamide • VUF-6,002 Reuptake Inhibitors Plasmalemmal ..... Vesicular VMAT Inhibitors Ibogaine • Reserpine • Tetrabenazine Enzyme Inhibitors Anabolism HDC Inhibitors α-FMH • Brocresine • Catechin • Cyanidanol-3 • McN-A-1293 • ME • Meciadanol • Naringenin • Thiazol-4-yimethoxyamine • Tritoqualine • Zy-15,029 Catabolism HNMT Inhibitors Amodiaquine • BW-301U • Diphenhydramine • Harmaline • Metoprine • Quinacrine • SKF-91,488 • Tacrine DAO Inhibitors 1,4-Diamino-2-butyne • Aminoguanidine Others Precursors L-Histidine Cofactors Vitamin B6 (Pyridoxine, Pyridoxamine, Pyridoxal → Pyridoxal Phosphate)

v • d • e Serotonergics Receptor ligands 5-HT1 5-HT1A Agonists: Azapirones: Alnespirone • Binospirone • Buspirone • Eptapirone • Gepirone • Ipsapirone • Perospirone • Tandospirone • Tiospirone • Zalospirone; Lysergamides: Dihydroergotamine • Ergotamine • Methysergide • LSD; Phenethylamines: MDA • MDMA; Piperazines: Eltoprazine • Flesinoxan • Flibanserin; Tryptamines: 5-CT • 5-MeO-DMT • 5-MT • DMT • Psilocin • Psilocybin • Rauwolscine • Yohimbine; Atypical Antipsychotics: Aripiprazole • Asenapine • Clozapine • Quetiapine • Ziprasidone; Others: 8-OH-DPAT • Befiradol • F-11440 • Lesopitron • Lu AA21004 • LY-293,284 • LY-301,317 • MKC-242 • Osemozotan • Piclozotan • PRX-00023 • Repinotan • RU-24969 • S-15535 • Sarizotan • SSR-181,507 • Sunepitron • U-92016A • Urapidil • Vilazodone • Xaliproden Antagonists: Beta Blockers: Alprenolol • Cyanopindolol • Iodocyanopindolol • Oxprenolol • Pindobind • Pindolol • Propranolol; Piperazines: Nefazodone • Trazodone • WAY-100,135 • WAY-100,635; Others: AV965 • BMY-7378 • Dotarizine • GR-46611 • Isamoltane • Lecozotan • Methiothepin • MPPF • NAN-190 • Robalzotan • S-15535 • SB-649915 • SDZ 216-525 • Spiperone • Spiramide • Spiroxatrine • UH-301 • WAY-100,135 • WAY-100,635 • Xylamidine 5-HT1B Agonists: Lysergamides: Dihydroergotamine • Ergotamine • Methysergide; Piperazines: Eltoprazine • TFMPP; Triptans: Eletriptan • Sumatriptan • Zolmitriptan; Tryptamines: 5-CT • 5-MT; Others: CP-93,129 • CP-94,253 • CP-135,807 • RU-24969 Antagonists: Lysergamides: Metergoline • Methiothepin; Tryptamines: Yohimbine; Others: AR-A000002 • GR-127,935 • Isamoltane • SB-216,641 • SB-224,289 • SB-236,057 5-HT1D Agonists: Lysergamides: Dihydroergotamine • Methysergide; Triptans: Almotriptan • Eletriptan • Frovatriptan • Naratriptan • Rizatriptan • Sumatriptan • Zolmitriptan; Tryptamines: 5-CT • 5-MT; Others: CP-135,807 • CP-286,601 • GR-46611 • L-694,247 • L-772,405 • PNU-109,291 • PNU-142,633 Antagonists: Lysergamides: Metergoline • Methiothepin; Tryptamines: Rauwolscine • Yohimbine; Others: Alniditan BRL-15572 • GR-127,935 • Ketanserin • LY-310,762 • LY-367,642 • LY-456,219 • LY-456,220 • Ritanserin • Ziprasidone 5-HT1E Agonists: Lysergamides: Methysergide; Triptans: Eletriptan; Tryptamines: Tryptamine Antagonists: Methiothepin 5-HT1F Agonists: Triptans: Eletriptan • Naratriptan • Sumatriptan; Tryptamines: 5-MT; Others: LY-334,370 Antagonists: Methiothepin 5-HT2 5-HT2A Agonists: Lysergamides: ALD-52 • Ergonovine • Lisuride • LA-SS-Az • LSD • Lysergic acid 2-butyl amide • Methysergide; Phenethylamines: 25I-NBMD • 25I-NBOH • 25I-NBOMe • 2C-B • 2C-B-FLY • 2C-E • 2C-I • 2C-T-2 • 2C-T-7 • 2C-T-21 • 2CBCB-NBOMe • 2CBFly-NBOMe • Bromo-DragonFLY • DOB • DOC • DOI • DOM • MDA • MDMA • Mescaline • Myristicin • TCB-2 • TFMFly; Piperazines: BZP • Quipazine • TFMPP; Tryptamines: 5-CT • 5-MeO-α-ET • 5-MeO-α-MT • 5-MeO-DET • 5-MeO-DiPT • 5-MeO-DMT • 5-MeO-DPT • 5-MT • α-ET • α-Methyl-5-HT • α-MT • Bufotenin • DET • DiPT • DMT • DPT • Psilocin • Psilocybin; Others: AL-34662 • AL-37350A • PNU-22394 Antagonists: Atypical Antipsychotics: Amperozide • Aripiprazole • Clozapine • Iloperidone • Melperone • Olanzapine • Paliperidone • Pimozide • Quetiapine • Risperidone • Sertindole • Ziprasidone • Zotepine; Typical Antipsychotics: Loxapine • Pipamperone; Antidepressants: Amitriptyline • Amoxapine • Etoperidone • Mianserin • Mirtazapine • Nefazodone • Trazodone; Others: 5-I-R91150 • AC-90179 • Altanserin • AMDA • APD-215 • Blonanserin • Cinanserin • Cyproheptadine • Deramciclane • Dotarizine • Eplivanserin • Fananserin • Flibanserin • Ketanserin • KML-010 • Lubazodone • Methiothepin • Nantenine • Pimavanserin • Pizotifen • Ritanserin • Sarpogrelate • Setoperone • Spiperone • Spiramide • SR-46349B • Volinanserin • Xylamidine • Yohimbine 5-HT2B Agonists: Oxazolines: 4-Methylaminorex • Aminorex; Phenethylamines: Chlorphentermine • DOB • DOC • DOI • DOM • Fenfluramine • MDA • MDMA • Norfenfluramine; Tryptamines: 5-CT • 5-MT • α-Methyl-5-HT; Others: BW-723C86 • Cabergoline • mCPP • Pergolide • PNU-22394 • Ro60-0175 Antagonists: Agomelatine • Asenapine • EGIS-7625 • Ketanserin • Lisuride • LY-272,015 • Rauwolscine • Ritanserin • RS-127,445 • Sarpogrelate • SB-200,646 • SB-204,741 • SB-206,553 • SB-215,505 • SB-221,284 • SB-228,357 • SDZ SER-082 • Tegaserod • Yohimbine 5-HT2C Agonists: Phenethylamines: 2C-B • 2C-E • 2C-I • 2C-T-2 • 2C-T-7 • 2C-T-21 • DOB • DOC • DOI • DOM • MDA • MDMA • Mescaline • Myristicin; Piperazines: Aripiprazole • mCPP • TFMPP; Tryptamines: 5-CT • 5-MeO-α-ET • 5-MeO-α-MT • 5-MeO-DET • 5-MeO-DiPT • 5-MeO-DMT • 5-MeO-DPT • 5-MT • α-ET • α-Methyl-5-HT • α-MT • Bufotenin • DET • DiPT • DMT • DPT • Psilocin • Psilocybin; Others: A-372,159 • AL-38022A • CP-809,101 • Lorcaserin • MK-212 • PNU-22394 • Ro60-0175 • Vabicaserin • WAY-629 • WAY-161,503 • YM-348 Antagonists: Atypical Antipsychotics: Clozapine • Iloperidone • Melperone • Olanzapine • Paliperidone • Pimozide • Quetiapine • Risperidone • Sertindole • Ziprasidone • Zotepine; Typical Antipsychotics: Chlorpromazine • Loxapine • Pipamperone; Antidepressants: Agomelatine • Amitriptyline • Amoxapine • Etoperidone • Fluoxetine • Mianserin • Mirtazapine • Nefazodone • Nortriptyline • Trazodone; Others: Cinanserin • Cyproheptadine • Deramciclane • Dimebolin • Dotarizine • Eltoprazine • FR-260,010 • Ketanserin • Ketotifen • Methysergide • Pizotifen • Ritanserin • RS-102,221 • SB-200,646 • SB-206,553 • SB-221,284 • SB-228,357 • SB-242,084 • SB-243,213 • SDZ SER-082 • Xylamidine 5-HT3 Agonists: Piperazines: BZP • Quipazine; Tryptamines: 2-Methyl-5-HT • 5-CT; Others: Chlorophenylbiguanide • RS-56812 • SR-57,227 • SR-57,227-A • YM-31636 Antagonists: Antiemetics: AS-8112 • Alosetron • Azasetron • Batanopride • Bemesetron • Cilansetron • Dolasetron • Granisetron • Lerisetron • Ondansetron • Palonosetron • Ramosetron • Renzapride • Tropisetron • Zacopride • Zatosetron; Atypical Antipsychotics: Clozapine • Olanzapine • Quetiapine; Tetracyclic Antidepressants: Amoxapine • Mianserin • Mirtazapine; Others: ICS-205,930 • Lu AA21004 • MDL-72,222 • Memantine • Ricasetron 5-HT4 Agonists: Gastroprokinetic Agents: Cisapride • Metoclopramide • Mosapride • Prucalopride • Renzapride • Tegaserod • Zacopride; Others: 5-MT • BIMU-8 • CJ-033,466 • PRX-03140 • RS-67333 • RS-67506 • TD-5108 Antagonists: GR-113,808 • GR-125,487 • L-Lysine • Piboserod • RS-39604 • RS-67532 • SB-203,186 5-HT5 5-HT5A Agonists: Lysergamides: Ergotamine • LSD; Tryptamines: 5-CT; Others: Valerenic Acid Antagonists: Asenapine • Dimebolin • Methiothepin • Ritanserin • SB-699,551 5-HT5B* Agonists: Lysergamides: Ergotamine • LSD Antagonists: Methiothepin * Note that the 5-HT5B receptor is not functional in humans. 5-HT6 Agonists: Lysergamides: Lisuride • LSD • Metergoline; Tryptamines: 5-CT • 5-MT • E-6801 • E-6837 • EMD-386,088 • EMDT • LY-586,713 • WAY-181,187 • WAY-208,466 Antagonists: Antidepressants: Amitriptyline • Amoxapine • Clomipramine • Doxepin • Mianserin • Nortriptyline; Atypical Antipsychotics: Aripiprazole • Asenapine • Clozapine • Fluperlapine • Iloperidone • Olanzapine • Tiospirone; Typical Antipsychotics: Chlorpromazine • Loxapine; Others: BGC20-760 • BVT-5182 • BVT-74316 • Dimebolin • EGIS-12233 • GW-742,457 • Ketanserin • Methiothepin • MS-245 • PRX-07034 • Ritanserin • Ro 04-6790 • Ro 63-0563 • SB-258,585 • SB-271,046 • SB-357,134 • SB-399,885 5-HT7 Agonists: Lysergamides: LSD; Tryptamines: 5-CT • 5-MT; Others: 8-OH-DPAT • AS-19 • Bifeprunox • LP-12 • LP-44 • Sarizotan Antagonists: Antidepressants: Amitriptyline • Amoxapine • Clomipramine • Imipramine • Maprotiline • Mianserin; Atypical Antipsychotics: Amisulpride • Aripiprazole • Clozapine • Olanzapine • Risperidone • Sertindole • Tiospirone • Ziprasidone • Zotepine; Typical Antipsychotics: Chlorpromazine • Loxapine; Others: EGIS-12233 • LY-215,840 • Mesulergine • Metergoline • Methiothepin • Pimozide • Ritanserin • SB-258,719 • SB-258,741 • SB-269,970 • SB-656,104 • SB-656,104-A • SB-691,673 • SLV-313 • SLV-314 • Spiperone • SSR-181,507 Reuptake inhibitors Plasmalemmal SERT inhibitors Selective Serotonin Reuptake Inhibitors (SSRIs): Alaproclate • Citalopram • Dapoxetine • Desmethylcitalopram • Desmethylsertraline • Elzasonan • Escitalopram • Femoxetine • Fluoxetine • Fluvoxamine • Indalpine • Litoxetine • Lubazodone • Norfluoxetine • Paroxetine • RTI-353 • Sertraline • Vilazodone • Zimelidine; Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Bicifadine • Desvenlafaxine • Duloxetine • Milnacipran • Venlafaxine; Serotonin-Norepinephrine-Dopamine Reuptake Inhibitors (SNDRIs): Brasofensine • Diclofensine • DOV-102,677 • DOV-21,947 • DOV-216,303 • NS-2359 • SEP-225,289 • SEP-227,162 • Tesofensine; Tricyclic Antidepressants (TCAs): Amitriptyline • Butriptyline • Cianopramine • Clomipramine • Desipramine • Dosulepin • Doxepin • Imipramine • Lofepramine • Nortriptyline • Protriptyline • Trimipramine; Tetracyclic Antidepressants (TeCAs): Amoxapine; Piperazines: Nefazodone • Trazodone; Antihistamines: Brompheniramine • Chlorpheniramine • Diphenhydramine • Mepyramine (Pyrilamine) • Pheniramine • Tripelennamine; Opioids: Meperidine (Pethidine) • Methadone • Propoxyphene • Tramadol; Others: Cocaine • Cyclobenzaprine (CBZ) • Dextromethorphan (DXM) • Mesembrine • Nefopam • SB-649,915 • Sibutramine • Ziprasidone TRPC6 activators Adhyperforin • Hyperforin Vesicular VMAT Inhibitors Ibogaine • Reserpine • Tetrabenazine Releasing agents Aminoindanes: Ethyltrifluoromethylaminoindane (ETAI) • Methylenedioxyaminoindane (MDAI) • Methylenedioxymethylaminoindane (MDMAI) • Methoxymethylaminoindane (MMAI) • Trifluoromethylaminoindane (TAI); Aminotetralins: 8-Hydroxydipropylaminotetralin (8-OH-DPAT); Oxazolines: 4-Methylaminorex (4-MAR, 4-MAX) • Aminorex • Clominorex • Fluminorex; Phenethylamines (also Amphetamines, Cathinones, Phentermines, etc): 4-Methylthioamphetamine (4-MTA) • 5-Aminopropyldihydrobenzofuran (5-APDB; 5-Desoxy-MDA) • Benzodioxolylbutanamine (BDB) • Benzodioxolylhydroxybutanamine (BOH) • Brephedrone • Butylone • Chlorphentermine • Diethylcathinone (Diethylpropion, Amfepramone) • Dimethoxyamphetamine (DMA) • Dimethoxymethamphetamine (DMMA) • Dimethylcathinone (Dimethylpropion, Metamfepramone) • Ethylbenzodioxolylbutanamine (EBDB) • Ethylone • Fenfluramine (Dexfenfluramine) • Flephedrone • Indanylamphetamine (IAP) • Lophophine (Homomyristicylamine) • Mephedrone • Methedrone • Methoxymethylamphetamine (MMA) • Methoxymethylenedioxyamphetamine (MMDA) • Methoxymethylenedioxymethamphetamine (MMDMA) • Methylbenzodioxolylbutanamine (MBDB) • Methylenedioxyamphetamine (MDA; Tenamfetamine) • Methylenedioxyethylamphetamine (MDEA) • Methylenedioxyhydroxyamphetamine (MDOH) • Methylenedioxymethamphetamine (MDMA) • Methylenedioxymethylphenethylamine (MDMPEA; Homarylamine) • Methylenedioxyphenethylamine (MDPEA; Homopiperonylamine) • Methylone • Naphthylamphetamine (NAP) • Norfenfluramine • Parabromoamphetamine (PBA) • Parachloroamphetamine (PCA) • Parafluoroamphetamine (PFA) • Parafluoromethamphetamine (PFMA) • Parahydroxyamphetamine (PHA) • Paraiodoamphetamine (PIA) • Paramethoxyamphetamine (PMA) • Paramethoxyethylamphetamine (PMEA) • Paramethoxymethamphetamine (PMMA); Piperazines: 2,5-Dimethoxy-4-bromobenzylpiperazine (2C-B-BZP) • Benzylpiperazine (BZP) • Metachlorophenylpiperazine (mCPP) • Methoxyphenylpiperazine (MeOPP; Paraperazine) • Methylbenzylpiperazine (MBZP) • Methylenedioxybenzylpiperazine (MDBZP; Piperonylpiperazine) • Parafluorophenylpiperazine (pFPP; Fluoperazine) • Trifluoromethylphenylpiperazine (TFMPP); Quinolines: PK-7059 • Viqualine; Tryptamines: Alphaethyltryptamine (AET; Etryptamine) • Alphamethyltryptamine (AMT; Metryptamine) Enzyme inhibitors Anabolism TPH inhibitors AGN-2979 • Fenclonine AAAD inhibitors Benserazide • Carbidopa Catabolism MAO Inhibitors Nonselective: Etryptamine • Furazolidone • Hydralazine • Iproclozide • Iproniazid • Isocarboxazid • Isoniazid • Linezolid • Mebanazine • Metryptamine • Nialamide • Phenelzine • Pheniprazine • Phenoxypropazine • Pivalylbenzhydrazine • Procarbazine • Safrazine • Tranylcypromine; MAO-A Selective: Befloxatone • Brofaromine • Cimoxatone • Clorgiline • Harmala alkaloids (Harmine, Harmaline, Tetrahydroharmine, etc) • Minaprine • Moclobemide • Pirlindole • Toloxatone • Tyrima Others Precursors L-Tryptophan → 5-HTP Cofactors Ferrous iron (Fe2+) • Magnesium (Mg2+) • Tetrahydrobiopterin • Vitamin B3 (Niacin, Nicotinamide → NADPH) • Vitamin B6 (Pyridoxine, Pyridoxamine, Pyridoxal → Pyridoxal phosphate) • Vitamin B9 (Folic Acid → Tetrahydrofolic acid) • Vitamin C (Ascorbic acid) • Zinc (Zn2+) Others Activity enhancers: Benzofuranylpropylaminopentane (BPAP) • Phenylpropylaminopentane (PPAP); Reuptake enhancers: Tianeptine

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