[19F] With brain fog, fatigue, itching, and anxiety after excessive Advil PM intake

Patient Description

A 19-year-old female presents with sudden onset of brain fog, fatigue, itching sensation described as feeling like a bug landing on her, and anxiety for the past 2 days. The patient reports confusion and mild double vision, along with mild headaches and dizziness. She accidentally took over 20 Advil PM tablets within a day, 3 days ago, and has since experienced nausea and vomiting. The patient has no rash, hives, or swelling, and no difficulty breathing or shortness of breath. She has a history of Celiac disease diagnosed a year ago and is allergic to Sulfamethoxazole. She is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Brain Fog and Fatigue

  • Overdose of Advil PM: Taking over 20 Advil PM tablets in a day can lead to significant side effects, including brain fog, fatigue, nausea, vomiting, and confusion. Advil PM contains diphenhydramine, which can cause drowsiness and confusion, especially in high doses.
  • Dehydration: Vomiting can lead to dehydration, which can also contribute to brain fog and fatigue.

Itchiness

  • Allergic Reaction: Although you haven't noticed any rash or hives, the sensation of itching all over could be a mild allergic reaction to something you've come into contact with or ingested.
  • Dry Skin: Sometimes, generalized itching can be due to dry skin, especially if you've been vomiting and possibly not drinking enough fluids.

Anxiety

  • Stress Response: The combination of your symptoms and the stress of feeling unwell can contribute to feelings of anxiety.

Double Vision

  • Medication Side Effect: High doses of diphenhydramine (found in Advil PM) can cause visual disturbances, including double vision.

What you can do

Brain Fog, Fatigue, and Double Vision

  • Seek Medical Attention: Given the high dose of Advil PM you took, it's important to seek medical attention immediately. Overdosing on medications can have serious consequences, and a healthcare professional can provide the appropriate treatment.
  • Stay Hydrated: Drink plenty of water to help flush the medication out of your system and to prevent dehydration from vomiting.
  • Rest: Ensure you get plenty of rest to help your body recover.

Itchiness

  • Moisturize: Apply a gentle, fragrance-free moisturizer to your skin to help alleviate itching.
  • Avoid Scratching: Try to avoid scratching the itchy areas to prevent skin irritation.
  • Cool Compress: Applying a cool, damp cloth to the itchy areas can provide some relief.

Anxiety

  • Deep Breathing: Practice deep breathing exercises to help manage anxiety.
  • Stay Calm: Remind yourself that you are taking steps to address your symptoms and that help is available.

What you should look out for

Given the severity of your symptoms and the potential for serious complications from an overdose, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Worsening Confusion or Drowsiness: If you become increasingly confused or drowsy, seek emergency medical care.
  • Difficulty Breathing: If you experience any difficulty breathing, seek emergency medical care immediately.
  • Persistent Vomiting: If you continue to vomit and cannot keep fluids down, seek medical attention to prevent dehydration.

Remember, while I can provide some guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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4 mo ago

People Also Ask


What are the potential side effects of taking too much Advil PM?

Taking too much Advil PM, which contains ibuprofen and diphenhydramine, can lead to side effects such as drowsiness, confusion, nausea, vomiting, dizziness, and visual disturbances like double vision. In severe cases, it can cause more serious health issues, so medical attention is necessary.


Can dehydration cause brain fog and fatigue?

Yes, dehydration can lead to brain fog and fatigue. When the body is dehydrated, it can affect cognitive function and energy levels, making a person feel tired and mentally sluggish.


What are some common causes of generalized itching without a rash?

Generalized itching without a rash can be caused by dry skin, mild allergic reactions, or even stress. It can also be a side effect of certain medications or a result of dehydration.


How can anxiety be managed when experiencing multiple symptoms?

Anxiety can be managed through deep breathing exercises, staying hydrated, ensuring adequate rest, and using relaxation techniques. It's also important to address the underlying causes of anxiety, such as health concerns, by seeking medical advice.


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