FORT WORTH, Texas — When a 14-year-old girl took 14 Benadryl pills in the middle of the night, her older sister called their grandmother for help, wanting to avoid getting in trouble with their parents.
“It was scary. She had fractured sentences, hallucinations. Her resting heart rate was 199,” the girl’s mother later said, according to Cook Children’s Health Care System, where the teen was treated in 2020.
Two other teenagers also were being treated for Benadryl overdoses at Cook Children’s at the time, after watching online videos on the popular social media platform TikTok. A year and a half later, Tarrant County teens are still being hospitalized after overdosing on Benadryl.
Two overdose incidents at Tarrant County high schools in late January raised alarms that the TikTok challenge could be recirculating.
On Jan. 28, five students at Haltom City’s Shannon High School overdosed on medication, and two were hospitalized. The day before, four students at Fort Worth’s Polytechnic High School were hospitalized for similar overdose symptoms after ingesting medication. Both school districts have declined to comment on the medication used or the cause of the overdoses.
What is the Benadryl challenge?
Benadryl, or diphenhydramine, is a common over-the-counter allergy medicine. It treats symptoms like rash, itching, watery eyes, cough, runny nose and sneezing. The Benadryl challenge, which started trending on TikTok in 2020, encourages teens to take an excessive amount as a deliriant.
“Each of these patients said they got the idea from videos on TikTok that claimed users could get high and hallucinate if they took a dozen or more of the allergy pills,” Cook Children’s said in 2020.
While the social media platform is popular for memes, dance challenges, beauty tutorials and cooking videos, the Benadryl challenge isn’t the only dangerous trend found there.
The 28% of TikTok users who are under 18 can be exposed to recent trends like the “sleepy chicken,” where users cook chicken in cough syrup, or the “blackout challenge,” which encourages users to hold their breath until they pass out.
“These challenges, they’re nothing new,” said Lizbeth Petty, public health education manager at the North Texas Poison Center. “You’re going to see them today, you’re going to see them tomorrow. They’re unlikely to go away, they get your attention.”
Is the Benadryl challenge trending in North Texas?
The North Texas poison control hotline often receives calls for Benadryl overdoses, some of which are related to the TikTok challenge.
“When you do start seeing these trending TikTok or social media challenges, we actually do tend to see an increase in volume and calls around that particular substance,” Petty said.
It’s most common among young teens, Petty says.
MedStar responded to the overdose incident at Shannon High School. One of the fire service personnel who was at the scene found a screenshot from the TikTok challenge on a teen’s phone, said Matt Zavadsky, a spokesperson for the EMS service.
“There was an indication that there may have been a TikTok challenge related to taking medication that’s not prescribed,” Zavadsky said. “What we heard was that it was encouraging people to take Benadryl.”
Why is this challenge circulating?
Petty said children are particularly susceptible to online challenges like this one.
“Their brain is still developing, and a big part of their brain that helps them think and make logical decisions or non-impulsive decisions is still not fully developed,” she said. “That is why younger kids and teens are more likely to take riskier decisions, because their brain is still going through development. That very well could be part of a reason why they’re more engaged in these challenges, because they don’t weigh the benefits versus the risk.”
Another reason is peer pressure. Petty says parents should acknowledge it exists, and reinforce that their children are not alone.
“One perspective that younger kids have is that because it’s over-the-counter, because it didn’t come from my doctor, it’s not harmful,” Petty said. “But some over-the-counter medicines can be even more harmful than those prescribed.”
Parents should let their children know that medications, whether they’re over-the-counter or prescription, can be equally as dangerous. Tell them that medications are considered drugs, which is something that changes the way your body works, Petty suggests.
What are the health risks?
Johnson & Johnson makes Benadryl. In a statement to the Star-Telegram, the company said: “This online ‘challenge’ is extremely concerning, dangerous and should be stopped immediately.”
In September 2020, the Food and Drug Administration issued a warning about serious health issues with high doses of Benadryl. Taking too much can lead to heart problems, seizures, coma or death, the FDA said.
Parents can look out for early symptoms including hallucinations, blurred vision, excessive drowsiness, loss of balance and chest pain, Petty said.
In some cases, the heart rate will return to normal without any lasting effects.
For others, the trend can be deadly. In summer 2020, a 15-year-old girl in Oklahoma named Chloe Marie Phillips died after taking part in the challenge.
What can parents do?
Johnson & Johnson said Benadryl should only be used as directed by the label.
“Parents and caregivers play an important role in identifying and addressing this concerning behavior and should be aware of signs of misuse and abuse,” the drug maker said. “All medications should be kept out of the reach of children at all times.”
Preventing teens from misusing medication can be tricky.
Petty recommends parents lock up Benadryl and other medicines.
“Most of them are not prepared to take medicine on their own unless they have been properly taught by an adult and they are under supervision of an adult when taking the medicine,” she said.
Encourage teens to read and follow the dose listed on the label, she says.
“They often don’t know how to read a Drug Facts label, which tells you very important information on dosing, warning and how to best use the medication,” Petty said.
According to directions on a bottle of Benadryl, children 6 to 12 should take one Benadryl tablet every four to six hours. Anyone over 12 could take one to two tablets every four to six hours. No more than six doses should be taken in 24 hours.
Petty also recommends having an open dialogue about challenges like this.
“You want to acknowledge that there is this challenge happening, you want to discuss it with them, let them kind of think through it,” she said.
If your child has a TikTok account, it’s a good idea to monitor their social media to some extent, says Zavadsky of MedStar.
“It would be important for the parents to know that this is a possibility in the area, and keep an eye on your kids’ behavior,” he said. “If you notice a significant shift in their behavior patterns, or if they get more secretive with regard to their social media, do a little more investigating, ask them if they’re having any issues, ask them if they’re participating in any potential challenges.”
What to do if an overdose happens
In the event that your child has taken too much Benadryl, immediately call 911.
While you’re waiting for an ambulance, don’t try to induce vomiting or give them anything to drink or eat. Contact poison control at 800-222-1222 for further instruction. They’ll let you know if your child will require hospitalization based on how much they ingested. If the overdose is due to a TikTok challenge, they may have taken a large dosage and will need to go to the hospital.
“We’ve taken action to stop this behavior from spreading,” the Johnson & Johnson statement read. “We work with social media platforms and their safety teams to remove these dangerous posts, including any new content we identify in our monitoring. We posted safety information on our Benadryl.com brand site and communicated with our retail partners and our industry trade associations to inform them about the ‘challenge.’ We’ve invested in research and data to understand the root causes of teen misuse and abuse of medicines and activated plans to educate teens, parents, caregivers and healthcare providers on appropriate use of diphenhydramine-containing products.”
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