Efficacy and central nervous system impairment of newer-generation prescription antihistamines in seasonal allergic rhinitis.
Allergic rhinitis is a highly prevalent disorder and oral antihistamines are often used to manage patient symptoms. Older-generation antihistamines, such as diphenhydramine and chlorpheniramine, are effective at relieving the symptoms of seasonal allergic rhinitis (SAR); however, they are associated with adverse events, including sedation and impairment, at, or above, the recommended dose. Newer-generation antihistamines, such as desloratadine, cetirizine and fexofenadine, were developed to minimize adverse events. In this article, studies examining newer-generation antihistamines in adults and children were reviewed. The clinical evidence confirms that desloratadine, cetirizine and fexofenadine are effective at managing the symptoms of SAR in adults and children; however, cetirizine is more likely to cause sedation. Physician intervention is paramount to SAR symptom management. It is essential that appropriate treatment relieves SAR symptoms with absent or minimal adverse events. This is particularly important for those patients involved in skilled and cognitive activities or safety-critical jobs.
Spangler
Dennis L
DL
Atlanta Allergy and Asthma Clinic, 1965 N. Park Place, N.W., Atlanta, GA 30339, USA. akspangler@mindspring.com
Brunton
Stephen
S
D002490:Central Nervous System / Q000187:drug effects; D017332:Cetirizine / Q000008:administration & dosage / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D017336:Loratadine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011788:Quality of Life; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D016593:Terfenadine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
D006634:Histamine H1 Antagonists; D039563:Histamine H1 Antagonists, Non-Sedating; D017336:Loratadine; D016593:Terfenadine; C093230:fexofenadine; D017332:Cetirizine