Difenhidramin: Perbedaan antara revisi

Difenhidramin dianggap memiliki potensi penyalahgunaan yang terbatas di Amerika Serikat karena profil efek sampingnya yang serius dan efek euforia yang terbatas, dan bukan merupakan zat yang dikendalikan. Sejak tahun 2002, FDA AS telah mewajibkan peringatan pelabelan khusus terhadap penggunaan beberapa produk yang mengandung difenhidramin.[94]<ref>{{cite journal | author = Food and Drug Administration, HHS | title = Labeling of diphenhydramine-containing drug products for over-the-counter human use. Final rule | journal = Federal Register | volume = 67 | issue = 235 | pages = 72555–9 | date = December 2002 | pmid = 12474879 | url = https://www.fda.gov/OHRMS/DOCKETS/98fr/120602a.htm | archive-url = https://web.archive.org/web/20081105004602/https://www.fda.gov/OHRMS/DOCKETS/98fr/120602a.htm | df = dmy-all | url-status = live | archive-date = 5 November 2008 }}</ref> Di beberapa yurisdiksi, difenhidramin sering terdapat dalam spesimen postmortem yang dikumpulkan selama penyelidikan kematian bayi mendadak; obat tersebut mungkin berperan dalam kejadian ini.[95][96]<ref name="pmid16419411">{{cite journal | vauthors = Marinetti L, Lehman L, Casto B, Harshbarger K, Kubiczek P, Davis J | title = Over-the-counter cold medications-postmortem findings in infants and the relationship to cause of death | journal = Journal of Analytical Toxicology | volume = 29 | issue = 7 | pages = 738–43 | date = October 2005 | pmid = 16419411 | doi = 10.1093/jat/29.7.738 | doi-access = free }}</ref><ref name="isbn0-9626523-7-7">{{cite book | vauthors = Baselt RC | title = Disposition of Toxic Drugs and Chemicals in Man | publisher = Biomedical Publications | year = 2008 | pages = 489–492 | isbn = 978-0-9626523-7-0 }}</ref>

Difenhidramin merupakan salah satu zat yang dilarang dan dikontrol di Republik Zambia,[97]<ref>{{cite web | url = http://www.gctrips.org/documents/IllegaldrugsinZambia.docx <!-- original "http://www.deczambia.gov.zm/listofdrugs.html link" is dead --> | format = DOC | title = List of prohibited and controlled drugs according to chapter 96 of the laws of Zambia | publisher = The Drug Enforcement Commission ZAMBIA | url-status = dead | archive-url = https://web.archive.org/web/20131116010729/http://www.gctrips.org/documents/IllegaldrugsinZambia.docx | archive-date = 16 November 2013 | df = dmy-all | access-date = 20 March 2013 }}</ref> dan wisatawan disarankan untuk tidak membawa obat tersebut ke negara tersebut. Beberapa orang Amerika telah ditahan oleh Komisi Penegakan Narkoba Zambia karena memiliki Benadryl dan obat-obatan lain yang dijual bebas yang mengandung difenhidramin.[98]<ref>{{cite web | url = https://travel.state.gov/content/passports/english/country/zambia.html | title = Zambia | work = Country Information > Zambia | publisher = Bureau of Consular Affairs, U.S. Department of State | access-date = 17 July 2015 | url-status = live | archive-url = https://web.archive.org/web/20150721232323/http://travel.state.gov/content/passports/english/country/zambia.html | archive-date = 21 July 2015 | df = dmy-all }}</ref>

Meskipun difenhidramin banyak digunakan dan umumnya dianggap aman untuk penggunaan sesekali, banyak kasus penyalahgunaan dan kecanduan telah didokumentasikan.[14]<ref name="Thomas2008">{{cite journal | vauthors = Thomas A, Nallur DG, Jones N, Deslandes PN | title = Diphenhydramine abuse and detoxification: a brief review and case report | journal = Journal of Psychopharmacology | volume = 23 | issue = 1 | pages = 101–5 | date = January 2009 | pmid = 18308811 | doi = 10.1177/0269881107083809 | s2cid = 45490366 }}</ref> Karena obat ini murah dan dijual bebas di sebagian besar negara, remaja yang tidak memiliki akses terhadap obat-obatan terlarang, sangat berisiko.[99]<ref name="urlAtypical Drugs of Abuse">{{cite web | url = http://studentdoctor.net/2008/07/atypical-drugs-of-abuse/ | title = Atypical Drugs of Abuse | vauthors = Forest E | date = 27 July 2008 | work = Articles & Interviews | publisher = Student Doctor Network | url-status = live | archive-url = https://web.archive.org/web/20130527231559/http://studentdoctor.net/2008/07/atypical-drugs-of-abuse/ | archive-date = 27 May 2013 | df = dmy-all }}</ref> Orang dengan masalah kesehatan mental—terutama penderita skizofrenia—juga rentan menyalahgunakan obat tersebut, yang diberikan sendiri dalam dosis besar untuk mengobati gejala ekstrapiramidal yang disebabkan oleh penggunaan antipsikotik.[100]<ref name="Halpert2002">{{cite journal | vauthors = Halpert AG, Olmstead MC, Beninger RJ | title = Mechanisms and abuse liability of the anti-histamine dimenhydrinate | journal = Neuroscience and Biobehavioral Reviews | volume = 26 | issue = 1 | pages = 61–7 | date = January 2002 | pmid = 11835984 | doi = 10.1016/s0149-7634(01)00038-0 | s2cid = 46619422 | url = http://www.queensu.ca/psychology/sites/webpublish.queensu.ca.psycwww/files/files/Faculty/Richard%20Beninger/Beninger_prp_25.pdf | access-date = 23 December 2017 | archive-date = 2 August 2020 | archive-url = https://web.archive.org/web/20200802230007/https://www.queensu.ca/psychology/sites/webpublish.queensu.ca.psycwww/files/files/Faculty/Richard%20Beninger/Beninger_prp_25.pdf | url-status = dead }}</ref>

Pengguna rekreasional melaporkan efek menenangkan, euforia ringan, dan halusinasi sebagai efek yang diinginkan dari obat tersebut.[100][101]<ref name="Halpert2002"/><ref>{{cite journal | vauthors = Gracious B, Abe N, Sundberg J | title = The importance of taking a history of over-the-counter medication use: a brief review and case illustration of "PRN" antihistamine dependence in a hospitalized adolescent | journal = Journal of Child and Adolescent Psychopharmacology | volume = 20 | issue = 6 | pages = 521–4 | date = December 2010 | pmid = 21186972 | pmc = 3025184 | doi = 10.1089/cap.2010.0031 }}</ref> Penelitian telah menunjukkan bahwa agen antimuskarinik, termasuk difenhidramin, "mungkin memiliki sifat antidepresan dan meningkatkan suasana hati".[102]<ref>{{cite journal | vauthors = Dilsaver SC | title = Antimuscarinic agents as substances of abuse: a review | journal = Journal of Clinical Psychopharmacology | volume = 8 | issue = 1 | pages = 14–22 | date = February 1988 | pmid = 3280616 | doi = 10.1097/00004714-198802000-00003 | s2cid = 31355546 }}</ref> Sebuah penelitian yang dilakukan pada pria dewasa dengan riwayat penyalahgunaan obat penenang menemukan bahwa subjek yang diberikan difenhidramin dosis tinggi (400 mg) melaporkan keinginan untuk menggunakan obat tersebut lagi, meskipun juga melaporkan efek negatif, seperti kesulitan berkonsentrasi, kebingungan, gemetar, dan penglihatan kabur.<ref>{{cite journal | vauthors = Mumford GK, Silverman K, Griffiths RR |title=Reinforcing, subjective, and performance effects of lorazepam and diphenhydramine in humans |journal=[103[Experimental and Clinical Psychopharmacology]] |date=1996 |volume=4 |issue=4 |pages=421–430 |doi=10.1037/1064-1297.4.4.421}}</ref>