Sneezing? Have a cold? Wheezing because of pollen? Take a cetirizine! This is what we do and have continued to do since so long, but, it may be now the time that we stop.

Diphenhydramine, a first-generation antihistamine approved in 1946, has long held a place in medicine cabinets worldwide. Commonly used to treat everything from seasonal allergies to bug bites, it also appears in nighttime cold medications and over-the-counter sleep aids. However, according to a recent review by allergy experts from Johns Hopkins University and the University of California, San Diego, it’s time to move on.

The study, published earlier this year, emphasized that while diphenhydramine does offer symptom relief, it comes with a host of potentially dangerous side effects, especially when safer, second-generation antihistamines like cetirizine, loratadine, and fexofenadine are readily available.

Dr. Anna Wolfson, an allergist at Massachusetts General Hospital, said she sees the medication misused in clinical settings far too often. “If someone has an allergic reaction to food, people will say, ‘Don’t worry, I have diphenhydramine in my purse,’ but really, epinephrine is the first-line treatment,” she noted. The sedative effect of the drug can actually mask worsening symptoms, putting patients in more danger. So if you thought sleeping it off helps, maybe not?

The Hidden Dangers: Sedation, Cognitive Impairment and Misuse

The review also highlighted how diphenhydramine interacts with the brain, often causing drowsiness, confusion, cognitive impairment, and even cardiac complications. These effects are more pronounced in older adults, where the drug’s effects can linger for up to 18 hours, leading to falls and disorientation.

In children, misuse has resulted in hospitalizations, paradoxical hyperactivity, and even fatalities, some tied to the viral and deadly “Benadryl Challenge” on TikTok.

The medication was also found to have no substantial clinical advantage over newer antihistamines in randomized trials. While it may reduce sneezing and itching, it offers minimal benefit for nasal congestion and often comes with more side effects.

Expert Insights on Tighter Oversight

Dr. Siri Kamath, a consultant in internal medicine at Gleneagles BGS Hospital in Bengaluru, agrees with the growing global consensus. “Diphenhydramine is an older antihistamine, and while it works, the safety cushion is thinner now, especially when anyone can buy it over the counter,” she said.

Dr. Kamath explains that while the drug can still be useful in emergencies, such as anaphylactic reactions when paired with epinephrine or in managing motion sickness and certain neurological conditions, its use in routine allergy management is unnecessary and potentially harmful.

She adds that regulatory bodies in India, such as the Central Drugs Standard Control Organization (CDSCO) and the Indian Pharmacopoeia Commission (IPC), monitor drug safety through real-world data. “When a drug begins doing more damage than healing, especially with safer choices available, it sparks a fresh look from regulators,” she notes.

Misuse Is a Key Part of the Problem

Diphenhydramine’s accessibility without prescription has made it susceptible to misuse. Dr. Kamath says it’s not just the drug’s inherent properties, but also the lack of awareness among the public and the way it’s marketed. “Clearer labels, more thoughtful dispensing by pharmacists, and public awareness can go a long way in preventing misuse,” she said. “We can’t overlook troubling trends online. This medicine does its job when used right, but without proper checks, its easy access can turn into a silent danger.”

This sentiment is echoed by American pharmacists and pediatricians who report that the medication is often misused in children for sleep and cold symptoms, despite its limited efficacy and serious risks. Saline drops, suctioning, or second-generation antihistamines like cetirizine are now preferred options for children above six months.

The Case for Moving Diphenhydramine Behind the Counter

Globally, experts are now calling for diphenhydramine to be either removed from the over-the-counter market or moved behind the counter to ensure pharmacist oversight.

In India, Dr. Kamath suggests tighter regulation rather than a blanket ban. “Instead of a full ban, we need better communication and tighter dispensing rules,” she said.

The Consumer Healthcare Products Association, which represents manufacturers like Benadryl's maker Kenvue, maintains that the medication is safe when used as directed and already includes clear warning labels. However, with over 1.5 million prescriptions still written annually in the U.S. alone, and countless untracked OTC purchases worldwide, some experts believe more than warning labels may be needed.

Balancing Familiarity with Evidence

For many patients and families, diphenhydramine is a go-to remedy that evokes familiarity and trust. But Dr. Kamath cautions against letting that history cloud present risks. “So many patients hold on to older medicines not out of defiance, but because they’ve leaned on them for years. But familiarity should never come at the cost of safety.”

West Nile Cases in the US: The United States seems to be facing a fresh health challenge this season. After a rise in COVID-19 cases, Los Angeles County has now confirmed its first human infections of West Nile virus for 2025.

According to LA County Department of Public Health officials, four residents have been hospitalised with the mosquito-borne illness between late July and late August. The patients are from the Antelope Valley, San Fernando Valley, and central Los Angeles, and all are currently recovering.

With West Nile virus once again making its presence felt, it is important to understand the disease and the precautionary steps that can help lower the risk of infection.

West Nile Virus: How the Virus Is Spreading In The US

West Nile virus continues to be the most widespread mosquito-borne illness in the continental United States. The World Health Organization warns that while most infections are mild or even unnoticed, the virus can, in rare cases, lead to fatal neurological disease.

Roughly 80% of people who contract West Nile show no symptoms at all. Transmission occurs primarily through the bite of infected mosquitoes. The first confirmed cases of the 2025 season were reported this week by the Los Angeles County Department of Public Health.

ALSO READ: West Nile Virus Isn't Over Yet, New Cases In US On Rise

“The first human cases of West Nile virus are an important reminder that we all need to take steps to prevent mosquito bites and mosquito breeding,” said Dr Muntu Davis, Los Angeles County Health Officer. He added that mosquitoes flourish in hot weather, which raises the risk of both bites and mosquito-borne illness.

West Nile virus is usually detected in LA County during the summer months, when warm overnight temperatures help mosquito populations thrive. On average, the county records about 56 human cases each year. Officials believe the real number is much higher, since most infections either cause no illness or only mild symptoms. Of those reported, however, three-quarters are considered severe, and about 10% of those cases result in death from complications.

What Are the First Signs of West Nile Virus?

Most people infected with West Nile virus never develop symptoms, about 80% remain asymptomatic. For the remaining 20%, the illness typically appears as West Nile fever, which includes flu-like signs such as fever, headache, fatigue, body aches, nausea, vomiting, and sometimes a rash on the trunk or swollen lymph nodes, according to the World Health Organization.

In rare cases, the infection can progress to a severe neuroinvasive disease such as encephalitis, meningitis, or poliomyelitis. Symptoms of this form include high fever, severe headache, neck stiffness, confusion, stupor, tremors, seizures, muscle weakness, paralysis, and in extreme cases, coma. Around 1 in 150 infected individuals develop such severe illness.

ALSO READ: West Nile Virus Spotted In Weld County Mosquitoes, Here’s What You Need To Know

Although serious disease can occur at any age, people over 50 and those with weakened immune systems such as transplant recipients face the highest risk of complications. The incubation period for West Nile virus usually ranges from 3 to 14 days after a mosquito bite.

West Nile Virus Treatment: Do We Have a Vaccine Yet?

There is currently no specific treatment or vaccine for West Nile virus in humans. Care is supportive, especially for patients with neuroinvasive disease. Severe cases may require hospitalization, intravenous fluids, respiratory support, and measures to prevent secondary infections.

West Nile Virus Precaution Tips

Since no licensed vaccine or medication exists to prevent West Nile virus, the most effective protection is avoiding mosquito bites. The U.S. Centers for Disease Control and Prevention recommends the following steps:

• Use insect repellent that is registered with the Environmental Protection Agency.
• Wear long, loose-fitting clothing to reduce exposed skin.
• Limit outdoor activity between dusk and dawn, when the mosquitoes that carry West Nile virus are most active.
• Keep mosquitoes out by using window and door screens or air conditioning where possible.

Prevention is always better than cure, and the simplest way to stay protected from West Nile virus is by keeping mosquitoes at bay.

Global pop star Selena Gomez has opened up about developing arthritis as a consequence of lupus. The singer, who has long been candid about her health challenges, was first diagnosed with lupus in 2013 and later underwent a kidney transplant.

In a recent conversation with Amy Poehler on her podcast ‘Good Hang with Amy Poehler,’ Gomez discussed her Rare Beauty brand, including its easy-to-use packaging, and shared how her personal health experiences influenced these choices. “I have arthritis in my fingers because of my lupus,” she said. “Before I started the right treatment, even simple things like opening a water bottle were really painful.”

What Is Lupus?

Lupus is an autoimmune condition that causes inflammation throughout the body. In this disease, the immune system mistakenly attacks healthy tissues instead of protecting them. Depending on which tissues are affected, lupus can impact the skin, blood, joints, kidneys, brain, heart, or lungs.

ALSO READ: Can Leg Workouts Help Protect Your Brain From Ageing? Expert Weighs In

Medically known as systemic lupus erythematosus (SLE), lupus can affect anyone, though it is far more common in women, particularly those between 15 and 45 years of age. Symptoms vary widely and may include joint pain, fatigue, rashes, and even complications involving internal organs. The disease is unpredictable—it can remain quiet for months and then flare up suddenly, often without warning.

For Selena Gomez, lupus has been more than a medical diagnosis; it has profoundly influenced her life. She first publicly shared her lupus diagnosis in 2015, explaining how she had to pause her career to focus on treatment.

How Does Lupus Trigger Arthritis?

On a recent episode of Good Hang with Amy Poehler, Selena Gomez revealed that lupus caused arthritis in her fingers. Unlike osteoarthritis, which results from joint wear and tear, lupus-related arthritis stems from immune system dysfunction. When the immune system attacks its own tissues, it can lead to:

• Inflammation and swelling in the joints, particularly in the hands, wrists, and knees
• Painful stiffness, often worse in the morning
• Flare-ups that make even simple tasks, like opening a water bottle, difficult

• Painless mouth sores
• Skin rashes, including the classic butterfly-shaped rash across the cheeks and nose
• Fatigue and unexplained fevers
• Chest pain or difficulty breathing
• Headaches, dizziness, brain fog, or confusion
• Sensitivity to light and hair loss

Early Signs of Lupus in Females

Lupus predominantly affects women, with about nine out of ten cases occurring in females. Early recognition is key to timely diagnosis and effective management. Common early signs include:

• Persistent fatigue
• Joint pain or swelling, especially in hands, wrists, and knees
• Skin rashes, particularly the butterfly-shaped rash across the cheeks and nose
• Hair thinning or hair loss
• Mouth sores
• Sensitivity to sunlight
• Raynaud’s phenomenon, where fingers and toes turn white or blue in response to cold or stress

Managing LupusCurrently, there is no cure for lupus. Treatment focuses on managing symptoms and reducing flare-ups, with the goal of putting the disease into remission, which means long periods without symptoms.

A 59-year-old woman came in for a follow-up visit for her shingles. During her appointment, she mentioned a small detail: she'd been feeling some skipped heartbeats, and her heart rate was a bit jumpy.

The woman had some preexisting health issues like being overweight, high blood pressure, high cholesterol, and prediabetes. Her comment about the jumpy heartbeat caught the attention of the doctor.

These small complaints led her doctor to do a more detailed check-up. An EKG, a test that checks the heart's electrical activity, revealed some key signs. The results showed that she had already suffered a heart attack, even though she hadn't felt it.

This was a 2023 case study published in the Cureus, doctors call this a "silent heart attack," or silent myocardial infarction (SMI). Unlike a typical heart attack, a silent one has no symptoms or only very mild ones, so people don't realize what's happening and don't get medical help. These cases are often discovered by chance during a routine check-up.

While you may not have heard of such cases before, they are not as uncommon as you may think they are. According to American Heart Association, of the estimated 805,000 heart attacks each year in US, 170,000 of them are silent heart attacks.

As the name suggests, these attacks are difficult to recognize but not impossible. We spoke to consultant interventional cardiologists Pankaj Vinod Jariwala of Yashoda Hospitals and Dr. P Praveen Kumar of Karpagam Hospital Dr. Krunal Tamakuwala KD Hospital, to understand more about it.

Who Is At Risk for Silent Heart Attacks?

Silent heart attacks are becoming more common, and they aren't just affecting older men. Doctors are now seeing them in people as young as their late 30s and early 40s, especially those with high-stress jobs. Dr Jariwala said, “They mistake early signs for lifestyle issues: acidity after a heavy dinner, shoulder pain from sitting at a laptop, or tiredness from long hours.”

As Dr. Krunal Tamakuwala points out, the real danger is not that these heart attacks are completely "symptomless," but that their symptoms are so common that they are easily ignored. By the time a person finally sees a doctor, their heart may already be seriously damaged. “Sometimes, it arrives silently, hidden behind complaints we consider minor. That is why doctors urge patients not to ignore symptoms that linger or feel unusual, even if they seem harmless at first.” explained Dr Tamakuwala

What Are The Symptoms Of Silent Heart Attacks?

Many people mistake the early signs of a silent heart attack for everyday issues. Symptoms like

• Acidity
• Shoulder pain
• Tiredness

These are often brushed off as normal problems from a busy lifestyle. In places like India, people tend to make the problem worse by self-medicating with antacids or painkillers, which only delays getting proper medical help.

The reason these heart attacks are so confusing is due to something called referred pain. According to Dr. P Praveen Kumar, the nerves that carry pain signals from the heart are the same ones that connect to the stomach, back, and shoulders. This means that a problem with your heart can cause discomfort in another part of your body.

For people with diabetes, the situation is even more complicated. They may not feel the classic chest pain at all because their nerve sensitivity is reduced. For them, a silent heart attack might feel like

• Simple bloating
• Indigestion
• A dull backache.

The key is to remember that not all heart attacks announce themselves with a dramatic crushing pain. Dr Praveen warns, “f these symptoms are joined by sweating, breathlessness, or dizziness, you should seek medical help immediately.”

Doctors emphasize that lifestyle choices are key to keeping your heart healthy. Regular exercise, a balanced diet, quitting smoking, and managing stress are no longer optional, especially in countries like India, where heart disease is affecting younger people. “Everyday aches may feel ordinary, but when it comes to the heart, they could be the difference between early intervention and irreversible damage.”