New directions and dimensions in the treatment of allergic rhinitis.

Physicians who treat patients with allergic rhinitis have a number of therapeutic options, including antihistamines, decongestants, cromolyn, anticholinergics, corticosteroids, and immunotherapy. Antihistamines are widely used for the treatment of mild allergic rhinitis and are often effective, although more severe cases will require other medications. The newer antihistamines may induce less drowsiness, which is the most prominent side effect of the older antihistamines. Topical nasal decongestants give fast relief from nasal congestion, but their overuse may result in rebound congestion. Because their efficacy in allergic rhinitis is variable, oral decongestants are usually used in combination with antihistamines. Nasal cromolyn is effective for many patients with allergic rhinitis, but its effect is variable and it is useful in severe allergic rhinitis.