Advil PM is a combination medication that contains ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, and diphenhydramine, an antihistamine with sedative properties used to help with sleep. When considering whether Advil PM is safe for Alzheimer’s patients, it is crucial to understand the effects of its components, especially diphenhydramine, on the brain and cognition.
Diphenhydramine, the sleep aid ingredient in Advil PM, has strong anticholinergic activity. Anticholinergic drugs block the neurotransmitter acetylcholine, which plays a critical role in memory, learning, and other cognitive functions. Research published in JAMA Neurology (2016) found that the use of anticholinergic medications is associated with increased brain atrophy, dysfunction, and clinical decline in older adults. This suggests that anticholinergic drugs may worsen cognitive impairment or accelerate decline in people with dementia or Alzheimer’s disease[1].
Further supporting this concern, a study in JAMA Internal Medicine (2015) concluded that higher cumulative use of anticholinergic medications is linked to an increased risk of developing dementia. The study emphasized the importance of raising awareness among healthcare professionals and older adults about the risks of long-term anticholinergic use to minimize exposure over time[1].
Because Alzheimer’s disease already involves a deficit in acetylcholine activity in the brain, medications that further reduce acetylcholine function, like diphenhydramine, can potentially exacerbate symptoms such as memory loss, confusion, and cognitive decline. Therefore, regular or long-term use of Advil PM or other diphenhydramine-containing products is generally discouraged in Alzheimer’s patients.
Regarding the ibuprofen component, NSAIDs like ibuprofen are primarily used for pain and inflammation. While NSAIDs do not have the same anticholinergic risks, their use in older adults must be cautious due to potential side effects such as gastrointestinal bleeding, kidney problems, and cardiovascular risks. These risks can be more pronounced in elderly patients, including those with Alzheimer’s disease, who may have other comorbidities or be on multiple medications.
Over-the-counter sleep aids containing diphenhydramine are approved only for short-term use. Medical experts advise against regular or nightly use, especially in older adults, due to risks of sedation, cognitive impairment, falls, and other side effects[2]. For Alzheimer’s patients, who are already vulnerable to confusion and falls, these risks are heightened.
In clinical practice, safer alternatives for managing sleep problems or pain in Alzheimer’s patients are preferred. Non-pharmacological approaches such as sleep hygiene, cognitive behavioral therapy for insomnia, and pain management strategies that do not involve anticholinergic drugs are recommended. When medication is necessary, healthcare providers often choose drugs with minimal cognitive side effects.
In summary, Advil PM is generally not considered safe for Alzheimer’s patients due to the diphenhydramine component’s anticholinergic effects, which can worsen cognitive decline and increase dementia risk. Occasional use might not cause immediate harm, but regular or long-term use should be avoided. Always consult a healthcare professional before giving any medication to someone with Alzheimer’s disease to ensure safety and appropriateness.
Sources:
[1] Peoples Pharmacy, “Sleeping Pills for Seniors: A Scary Solution for Insomnia,” citing JAMA Neurology (2016) and JAMA Internal Medicine (2015)
[2] SingleCare, “Is it safe to take OTC sleep aids every night?” with expert commentary from Dr. Philip Alapat
