Doctor Warns of Common Medication Risks
A prominent physician has raised alarms over a frequently used medication that may lead to serious health issues, including organ failure and dementia.
Dr. Ethan Melillo, a pharmacist based in Rhode Island, has expressed strong disapproval of Tylenol PM, one of the most popular nighttime pain relievers in the U.S., which generates nearly $1 billion in sales annually.
According to Dr. Melillo, the inexpensive pills, priced at about 17 cents each, are often misused by many individuals seeking relief from headaches and minor discomforts.
He warns that regular use can result in significant liver damage due to acetaminophen, the active ingredient in Tylenol.
Additionally, the sedative diphenhydramine, also found in the medication, may contribute to memory loss.
When the body metabolizes acetaminophen, it produces a small quantity of a harmful byproduct known as NAPQI. Typically, a natural antioxidant called glutathione in the body neutralizes this toxic compound. However, if high doses of acetaminophen are consumed or if glutathione levels are compromised due to alcohol use or poor nutrition, the liver can struggle to process NAPQI effectively.
This accumulation can lead to serious cellular injury and, ultimately, liver failure.
Dr. Melillo emphasizes that the risk of liver damage greatly intensifies when adults exceed 4,000 mg of acetaminophen daily, which would mean taking more than eight Tylenol PM tablets.
He also points out that acetaminophen is a component in numerous medications beyond just Tylenol PM, advising consumers to check labels for acetaminophen content.
While he doesn’t advise against using acetaminophen altogether, he suggests it should not be a regular choice.
The prevalence of acetaminophen use might be a contributing factor to the high levels of liver damage in the U.S., where liver disease affects one in three people, amounting to around 100 million individuals.
In 2011, the FDA requested that manufacturers limit acetaminophen in combination products to a maximum of 325 mg per tablet or capsule, citing a lack of evidence that doses above this amount provided additional benefits while increasing liver injury risks.
Notably, each Tylenol PM tablet contains 500 mg of acetaminophen along with 25 mg of diphenhydramine to assist with sleep.
Further research has suggested that acetaminophen may alter perceptions of risk, making some activities appear less dangerous. In one study, participants under the influence of the drug rated activities like bungee jumping or starting a new career as less risky than those who received a placebo.
Another study from Ohio State University found that acetaminophen affected emotional perceptions, dulling both positive and negative feelings, including empathy and joy.
Dr. Melillo has reservations about diphenhydramine, a common antihistamine that can induce drowsiness. He noted that many people recognize it by its brand name, Benadryl.
He cautions that it could potentially lead to memory issues due to its anticholinergic properties, which block acetylcholine—a neurotransmitter crucial for memory and cognitive functions.
One particular study indicated that chronic use of an anticholinergic medication for three years or longer may elevate dementia risk by 54% compared to limited use of three months or fewer.
Other side effects from diphenhydramine include dry mouth and urinary retention, which may be especially problematic for older adults and could exacerbate other health issues.
If individuals seek help with sleep, Dr. Melillo recommends consulting with a doctor regarding prescription alternatives instead of relying on Tylenol PM or Benadryl, which could lead to dependency.
He adds, “If you only use this occasionally, that’s fine. It’s not a major issue. But this shouldn’t be your go-to for sleep every night… it’s important to prevent long-term complications.”
