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Pharmaceuticals/tardive dyskinesia

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QUESTION: dr salman,need the advice of a expert.i read the internet,unfortunetly lots of medical articles are false and alarming,i take 20 mg of hydroxyzine 3 or 4 times a week for hives.i also have taken 1mg of Xanax for 4 years.now the internet bull said either of these drugs can cause tardive dyskinesia.of course they don't give percentages.thibk Benadryl is safer and im 80 but have no problem urinating.please clear this up for me

ANSWER: Although tardive dyskinesia by Xanax or hydroxyzine have not been reported, Xanax has been known to cause akathisia, rigidity and tremors in 1-4% patients. Involuntary motor activity, including rare instances of tremor and convulsions, has been reported with hydroxyzine, usually with doses considerably higher than those recommended. Benadryl, on the other hand, treats tardive dyskinesia.

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QUESTION: Benadryl is fiercely told that people over 65 should avoid it like the plague.getting back to me im 79 and have diabetes and hypertension all under excwllent control.taking 20mg of hydroxyzine daily I think is safe with a chance of tardive dyskinesia zero.from what I read hydroxyzine has no harmfull effect on kidneys,liver or renal.my alleregist said he never heard ofhydroxyzine causing tardive dyskinesia.so in a nutshell I think hydroxyzine 5 times a week at low doseage is ok.at 79 with slightly enlarged prostate is not Benadryl dangeroius?

Answer
Diphenhydramine is not recommended for patients older than 60 unless a physician is consulted. Due to its strong anticholinergic effects, diphenhydramine is on the "Beers list" of drugs to avoid in the elderly. In people with enlarged prostate, it can cause urinary retention. So, hydroxyzine is OK for you.

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Dr Mohd Tariq Salman

Expertise

I can answer questions related to indications (therapeutic uses), contraindications, adverse reactions and interactions of drugs. I can also give expert opinion on queries related to rational use of medicines, including cost effective medication, essential medicines and generic drugs.

Experience

Teaching and training of undergraduate medical, dental and pharmacy students, supervision of pharmacology residents and research on herbal drugs, pharmacovigilance and drug utilization studies.

Organizations
Era's Lucknow Medical College, Jawaharlal Nehru Medical College, Indian Pharmacological Society, Society of Pharmacovigilance India, Association of Medical Pharmacologists of Imdia.

Publications
British Journal of Clinical Pharmacology, JK Science, Natural Product Radiance, Hippocratic Journal of Unani Medicine, Indian Journal fot the Practicing Doctor, Unimed Kulliyat.

Education/Credentials
MBBS, MD (Pharmacology)

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