Reader question: Which antihistamine is the best?

Antihistamines

In my last post I briefly went over allergic rhinitis. In response I received a few requests for advise on how to choose an antihistamine or which one is best.

I usually don’t endorse any specific drug, as medical decisions are usually individualized to the patient by the treating physician. I will, however, briefly discuss the salient features of my favorites, and why I might consider one over the other.

Itchy, runny, stuffy, allergies.

Allergic and Perennial (non allergic) Rhinitis and rhino-sinusitis

I have long since suffered from seasonal allergies - and it sucks. Unfortunately, both seasonal allergic as well as perennial non allergic rhinitis are common. Usual symptoms may include runny or itchy nose, stuffy nose, sinus pressure, headaches, cough, and mucus pooling in the throat. Some of my patients with chronic rhinitis are so used to their symptoms that they are barely aware of them. I often observe them clearing their throat, or swallowing mucus continually during their office visit, and they don’t even realize it! Some of the symptoms of rhinitis are a nuisance, but others can be problematic, and are best treated under the guidance of your doctor.

In their evaluation, I usually divide my patients symptoms into the itchy, runny symptoms, associated with profuse thin discharge, and congested, pressure symptoms associated with thick discharge.

Muscle aches from your statin?

Statin Myopathy

It's a common scenario, you walk out of a doctors office with a plan of care that has you all pumped to improve your health - only to realize you can't carry it through. As physicians we often frown at these “excuses” and label patients as noncompliant rather than address the barriers to therapy. If you can't make it to a physical therapist for your neck strain, we need to work on an alternative plan of care - not simply expect a single mom to miss work because we said so. There is usually more then one way to skin a cat (no cats were skinned in the writing of this post). Similarly, as a patient, if you feel you are having a side effect of a medication, talk to your doctor - it may be more common then you think - and likely have an easy fix. In today's post I am going to address a common side effect of one of the most commonly prescribed medications known to reduce cardiovascular disease - Statins.