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Donepezil: an unusual therapy for acute diphenhydramine overdose
  1. Jamia Ahmad1,
  2. Md Jahidul Hasan2,
  3. Ahmad Mursel Anam1 and
  4. Dipesh Kumar Barua1
  1. 1 Intensive Care Unit, Square Hospitals Ltd., Dhaka, Bangladesh
  2. 2 Department of Pharmacy, Square Hospitals Ltd., Dhaka, Bangladesh
  1. Correspondence to Dr Ahmad Mursel Anam, murselanam{at}


An elderly man presented with the history of diphenhydramine hydrochloride overdose as a suicidal attempt. At presentation, he was in an acute confusional state with several anticholinergic features and had to be managed in intensive care unit. As an antidote for diphenhydramine hydrochloride, donepezil was used instead of physostigmine due to the unavailability of physostigmine in Bangladesh. The patient improved within the next 24 hours; his level of consciousness improved and the anticholinergic features regressed.

  • poisoning
  • drug misuse (including addiction)
  • therapeutic indications

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  • Contributors JA, MJH and AMA: contributed to the conception, design, analysis and interpretation of the data. Also responsible for the drafting the article and the final approval of the version to be published; and in revising the manuscript critically for important intellectual content. JA, AMA and DKB: contributed in treatment of the patient. All authors: read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent obtained.