OKLAHOMA CITY (KFOR) – Nex Benedict, 16, died of a combination of a toxic level of Diphenhydramine and Fluoxetine, and the probable cause of death is suicide, according to a report from the Oklahoma State Medical Examiner’s office.

Nex Benedict, whose family says the teen was bullied at Owasso High School in Oklahoma, died a day after the fight inside a girl’s bathroom at the school. According to family, Benedict identified as nonbinary and used they/them pronouns.

Benedict told police what happened in a video released Feb 23rd.

Benedict walked out of the bathroom after the Feb. 7 fight but was taken to a hospital by their family and sent home that night. Paramedics were dispatched to the home the following day for a medical emergency and took Benedict to a hospital emergency room, where they later died, police said.

Benedict’s mother, Sue Benedict, has said the teen suffered bruises all over their face and eyes in the fight involving a transgender student and three older girls.

The school district has said the students were in the restroom for less than two minutes before the fight was broken up by other students and a staff member.

Fluoxetine is FDA-approved for major depressive disorder (for patients eight years and older), obsessive-compulsive disorder, panic disorder, bulimia, binge eating disorder, premenstrual dysphoric disorder, and bipolar depression as well as treatment-resistant depression when used in combination with olanzapine.

It also has several non-FDA-approved indications. This activity outlines the indications, mechanism of action, dosing, important adverse effects, contraindications, monitoring, and toxicity of fluoxetine, so providers can direct patient therapy to optimal outcomes in combating psychological conditions for which it is indicated.

Diphenhydramine – perhaps known most commonly as its brand name formulation Benadryl – is a first-generation H1 receptor antihistamine that is used extensively for the treatment of seasonal allergies, insect bites and stings, and rashes.

However, it also has antiemetic, antitussive, hypnotic, and antiparkinson properties. As histamine receptors exist both peripherally and in the central nervous system, diphenhydramine has been shown to cause sedation due to its competitive antagonism of histamine H1 receptors within the central nervous system.

While its use in allergy therapy can sometimes fall out of favor due to its sedative effect, diphenhydramine has been repurposed for use within many non-prescription over-the-counter sleep aids and cough-and-cold medications that have been marketed for “night time” use.

Diphenhydramine is also used in combination with [DB14132] as the anti-nausea drug [DB00985] where it is utilized primarily for its antagonism of H1 histamine receptors within the vestibular system. Diphenhydramine has also been shown to be implicated in a number of neurotransmitter systems that affect behaviour including dopamine, norepinephrine, serotonin, acetylcholine, and opioid.

As a result, diphenhydramine is being investigated for its anxiolytic and anti-depressant properties.

Benedict’s untimely death has generated huge support from the local LGBTQ community and allies in Oklahoma.

The full ME report will be released in 10 business days in compliance with state law.