How common is substance intoxication involving the combination of diphenhydramine, ethanol, cetirizine, and amphetamine, as seen in Anne Burrell's case?



The combination of diphenhydramine, ethanol, cetirizine, and amphetamine can lead to acute intoxication, as noted in the case of Food Network star Anne Burrell. While specific statistics on the commonality of this exact combination are not readily available, understanding the individual substances and their potential interactions is crucial.
### What substances were involved in Anne Burrell's case?
Food Network star Anne Burrell's cause of death was officially determined by the New York City medical examiner's office to be "acute intoxication due to the combined effects of diphenhydramine, ethanol, cetirizine, and amphetamine." This combination includes an antihistamine (diphenhydramine), alcohol (ethanol), another antihistamine (cetirizine), and a stimulant (amphetamine).
### What are the potential effects of combining these substances?
Combining these substances can amplify their effects and lead to unpredictable and dangerous outcomes. Diphenhydramine and cetirizine are antihistamines that can cause drowsiness and sedation. Ethanol, or alcohol, is a central nervous system depressant that can impair judgment and coordination. Amphetamine is a stimulant that increases alertness and energy. When taken together, these substances can create a complex mix of depressant and stimulant effects, potentially leading to severe health consequences, including respiratory depression, cardiac issues, and altered mental states. The interaction between these drugs can exacerbate their individual side effects, making such a combination particularly hazardous.
### Are there documented cases or studies on the co-ingestion of these specific drugs?
Specific research focusing on the co-ingestion of this precise combination of diphenhydramine, ethanol, cetirizine, and amphetamine is limited in publicly accessible literature. However, the general principle of polydrug use, where multiple substances are consumed concurrently, is a well-documented phenomenon in toxicology and emergency medicine. Studies on polydrug abuse often highlight the increased risks associated with mixing different classes of drugs, including stimulants, depressants, and antihistamines, due to the complex and often synergistic interactions that can occur. These interactions can lead to more severe adverse effects than would be expected from any single substance alone.
### How can individuals ensure safe medication and alcohol consumption?
Ensuring safe consumption involves being fully aware of the ingredients in any medication, including over-the-counter drugs, and understanding their potential interactions with alcohol or other substances. It is always advisable to read medication labels carefully and consult with a healthcare professional or pharmacist if there are any doubts about potential interactions. Avoiding the consumption of alcohol while taking medications, especially those known to cause drowsiness or affect the central nervous system, is a critical safety measure. For those with conditions requiring stimulant medication, such as ADHD, careful monitoring and adherence to prescribed dosages are essential, and any combination with alcohol or other substances should be strictly avoided unless explicitly cleared by a doctor.
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## References
* https://www.washingtonpost.com/food/2025/07/24/anne-burrell-death-suicide-food-network/
* https://ca.news.yahoo.com/anne-burrell-cause-death-ruled-154249110.html
* https://cbsaustin.com/news/entertainment/anne-burrell-cause-of-death-revealed-food-network-star-was-55
* https://timesofindia.indiatimes.com/life-style/food-news/anne-burrells-cause-of-death-revealed-food-network-star-died-by-suicide/articleshow/122896143.cms
* https://www.nytimes.com/2025/07/24/dining/anne-burrell-death-suicide.html