Social media challenge: Encouraging adolescents to engage in dangerous over-the-counter drug use

Social Media Challenge: Encouraging Adolescents to Engage in Dangerous Over-the-Counter Drug Use 

The trend began on TikTok in 2020 but has since expanded to other social media platforms 

DENVER — Adolescents and young adults are misusing common over-the-counter antihistamines, putting them at risk of severe health outcomes including heart arrythmias, seizures or death, according to research presented during the American Academy of Pediatrics 2025 National Conference & Exhibition at the Colorado Convention Center from Sept. 26-30.  

Noelia Swymeler, study author and pediatric resident physician at the University of Oklahoma at Tulsa School of Community Medicine, said trends such as the “Benadryl Challenge” circulating on social media are fueling the rise in these dangerous activities.  

Her abstract, “Toxic Trends: The Hallucinatory Appeal of the TikTok Benadryl Challenge,” states that the 2020 TikTok challenge encouraged viewers to ingest high doses of over-the-counter allergy medicine containing diphenhydramine, which has sedating effects. Teens fight the drowsiness the medication causes in order to experience a high and hallucinations. 

“The fact that we continue to see spikes in harmful diphenhydramine use years after the challenge first went viral shows just how powerful and dangerous social media trends can be,” Swymeler said. 

Diphenhydramine is a first-generation antihistamine that, when misused, can cause severe toxicity, including arrhythmias, seizures, coma, and death. 

Research authors urge parents, healthcare professionals, and social media companies to be on the alert for dangerous video challenges because the information remains accessible online long after their initiation. Authors advise families to ensure medications are safely stored away to prevent misuse. 

“This research highlights the need for better education, stronger safeguards, and continued awareness to prevent teens from being harmed by medications they can easily find in their own homes,” Swymeler said. 

The authors did not receive financial support for this research. 

Study author Noelia Swymeler is scheduled to present her research, which is below, from 12:30 p.m. – 1:30 p.m. MDT on Sunday, Sept. 28 in the Colorado Convention Center, Four Seasons Ballroom 1 & 2. To request an interview with the authors, contact Bonnie Rucker at brucker@ou.edu. 

In addition, Ms. Swymeler will be among highlighted abstract authors who will give a brief presentation and be available for interviews during a press conference from noon-1:30 p.m. MDT Saturday, Sept. 27, in the National Conference Press Room, CCC 705/707. During the meeting, you may reach AAP media relations staff at 303-228-8338.   

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

Program Name: 2025 Call for Abstracts

Submission Type: Council on Adolescents and Young Adults

Abstract Title: Toxic Trends: The Hallucinatory Appeal of the TikTok Benadryl Challenge

Noelia Swymeler

Tulsa, OK, United States

The "Benadryl Challenge" is a dangerous social media trend promoted by adolescents and young adults that emerged on TikTok in 2020, encouraging individuals to ingest over 300mg of diphenhydramine to induce hallucinations or get “high.” Diphenhydramine, a first-generation antihistamine with anticholinergic properties, is widely available over the counter and, when misused, can cause severe toxicity, including arrhythmias, seizures, coma, and death. Although gaining attention in 2020, the challenge resurfaced in 2023, with case reports continuing despite efforts to eliminate the trend, highlighting its ongoing impact. We hypothesized that this social media trend would increase the number of diphenhydramine-related adverse event reports to the FDA’s Adverse Event Reporting System (FAERS).

A retrospective study was conducted using diphenhydramine-related adverse event reports in individuals 10-25 years of age from January 2013 to December 2024 from FAERS. Reports were pulled from FAERS using all single ingredient Benadryl and diphenhydramine product names. Reports were removed if they were duplicates, occurred outside the US, listed additional suspected ingredients, or had reasons for use inconsistent with the study objective. May 2020 marked the challenge’s emergence with the first reported challenge-related hospitalization. We utilized data from January 2013 to April 2020 to forecast trends in reports via Auto Regressive Integrative Moving Average (ARIMA) modeling for May 2020 through December 2024 to determine if the “Benadryl Challenge” had a significant impact on adverse event reports to the FDA. Model performance was assessed via RMSE, MASE, and ACF1.

A total of 413 reports met study inclusion criteria. The number of reports across years varied with 2013 and 2016 having the lowest number of reports (n=7) and 2023 having the highest (n=73) followed by 2020 (n=62; Figure 1). From January 2013 to April 2020, monthly reports ranged from 0 to 16. The forecasted monthly report counts from May 2020 to December 2024 ranged from 2.13 to 6.63 (Figure 2, RMSE=2.85, MASE=.88, ACF1=.045). Reports exceeded forecasted amounts several times after April 2020 including July 2020, December 2020, July 2021, February 2023, May 2023, January 2024, and June 2024.

While the increase in diphenhydramine-related adverse event reports may not be directly attributed to the "Benadryl Challenge," the continued rise in cases among adolescents and young adults underscores a concerning national trend warranting healthcare provider attention. Peaks in reporting coincided with the challenge’s emergence, while declines may have resulted from public health advisories or other factors, requiring further analysis. These findings highlight the need for continued vigilance among healthcare providers, public health officials, and policymakers to address the risks of over-the-counter medication misuse, particularly in the context of evolving social media trends. Strengthening preventive strategies, including education and monitoring, may help mitigate future harm.

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Figure 1. Number of diphenhydramine-related adverse event reports across years

Trends in the frequency of diphenhydramine-related adverse event reports using FAERS from January 2013 to December 2024, with the introduction of the “Benadryl Challenge” being in May 2020.

Figure 2. Comparison of projected and actual adverse event reports including diphenhydramine in the United States from January 1, 2013 to December 31, 2024

The red solid line represents projected diphenhydramine-related adverse event reports starting with the emergence of the “Benadryl Challenge" in May 2020 to December 2024 using ARIMA modeling while the dotted line represents the upper 95% confidence interval. The blue line represents actual diphenhydramine-related adverse event reports from January 2013 to December 2024.

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.   

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