Antihistamines May Impair Performance - Brief Article

New medical guidelines for treatment of inflammation of the mucous membrane of the nose warn that older, but commonly used, antihistamines may have serious side effects. "There is very disturbing evidence that first-generation antihistamines can play a role in fatal automobile accidents and occupational injuries," explains Mark S. Dykewicz, associate professor of internal medicine and director of the training program in allergy and immunology at Saint Louis (Mo.) University School of Medicine. "In fact, data suggest that there is higher risk for occupational accidents from first-generation antihistamines than from use of narcotics and prescription sedatives. These older antihistamines also have been shown to impair children's learning and school performance."

Allergic rhinitis (hay fever), the most common form of rhinitis, affects 20-40,000,000 Americans annually, including 10-30% of adults and up to 40% of children. Symptoms often include nasal congestion, sneezing, itching of the nose, and postnasal drainage. The cost of rhinitis is estimated to exceed $10,-000,000,000 a year in the U.S., including direct expenses of medical care and indirect costs from decreased workplace productivity and lost work days.

First-generation antihistamines in many over-the-counter and some prescription allergy, sinus, and cold treatments can cause not only sedation, but impairment in thinking that may be dangerous. Similar to the effects of alcohol, they may trigger delayed reaction times, difficulties in focusing on tasks, and decreased memory. Studies show that people often have these problems, yet don't sense it because they don't feel sleepy.

The new practice parameters recommend that second-generation antihistamines--such as Allegra, Claritin, Hismanal, and Zyrtec--that are associated with less or no risk of these side effects should be considered first-line therapy for allergic rhinitis before sedating antihistamines. The first intranasal antihistamine, asteli, is a preferred medication as well.

The guidelines also discourage the use of cortisone steroid injections prescribed by some physicians for seasonal hay fever. Although one injection can provide relief for up to three or four weeks, they maintain that the potential for hormonal and other side effects is much greater than with safer alternatives, such as nasal cortisone sprays or, if needed for severe nasal symptoms, three-to seven-day courses of oral cortisone medications.

COPYRIGHT 2000 Society for the Advancement of Education
COPYRIGHT 2000 Gale Group