Allergies Health Center
Antihistamine FAQ
Question:
What exactly do antihistamines do? Are over-the-counter antihistamines safe for children to take regularly for allergies?
Answer:
Answer: Allergic triggers such as pollen prompt mast cells
(frontline defenders of the body) to release a chemical called histamine that
sets in motion a cascade of symptoms to repel the invaders. We call it
‘allergies’ when this response is triggered by something that would not
otherwise be harmful for the body.
Antihistamines reduce allergy symptoms by blocking the action of the histamine.
These can be very effective, but all of the over-the-counter antihistamines
cause some change in kids' levels of alertness. Most of the time, they produce
drowsiness in children (which can be quite welcome -- especially at night), but
around 5% of kids act hyper instead.
Of far greater concern is the effect of over-the-counter antihistamines on
thinking and learning. We know that kids who are experiencing allergy symptoms
don't think or learn or remember as well as kids who are feeling well (Annals
of Allergy, Aug 1993). Careful studies have now been performed to determine
whether this reduction in learning ability could be reversed by using
over-the-counter antihistamines to relieve the allergy symptoms. The surprising
results were that even though kids felt better on the antihistamines, their
learning abilities were even worse than with no treatment (Annals of Allergy,
Asthma, and Immunology, Mar 1996). They’re learning and mental agility is
reduced whether or not they are drowsy. Children are better off congested than
drugged. (Better yet is relieving the symptoms in less problematic ways!)
Over-the-counter antihistamines are a reasonable choice for nighttime use, or
for an occasional day or two when a child is home from school. I do not
recommend them, however, as a long-term solution. Learning --even during play
-- is too important a part of childhood to blunt with drugs. Some of the
prescription antihistamines do not decrease alertness or learning.
Antihistamines are found in almost all allergy preparations that are not
specifically advertised as non-drowsy. Diphenhydramine is the most powerful,
but it also makes kids the sleepiest (or most wired). Chlorpheniramine and
brompheniramine both are a little less potent but have fewer side
effects.
Nasalcrom is an exciting, new, over-the-counter allergy medicine that is more
effective and far safer than either decongestants or antihistamines. Nasalcrom
is a nasal spray that creates a protective barrier around the allergy cells in
the nose so that pollen, mold, dust, and animal dander can't stick to them. It
stops the allergic response before it starts--without causing any drowsiness,
irritability, or decreased learning. It doesn't reverse allergy symptoms that
are already present, but prevents new allergen exposures from causing symptoms.
Unlike decongestant nasal sprays, this gentle medicine can be used for weeks or
months at a time with no fear of rebound effects or addiction.
WebMD Answers to Questions from DrGreene.com



