If You Take It, You 'Snore'; If Not, You 'Sniffle'... Is There a Non-Drowsy Allergy Medicine?[MZ Generation Health Care]

Improvement of Drowsiness Side Effects from Second-Generation Antihistamines
Treatment Methods Including Environmental Therapy and Immunotherapy

[Asia Economy Reporter Kim Young-won] "If I take medicine, I quickly get drowsy and can't concentrate, but if I don't take it, I worry that sneezing or sniffling will bother those around me."

Job seeker Kim (24) faces the same dilemma before spring and fall recruitment written exams. Kim, who suffers from allergic rhinitis, finds that symptoms subside quickly when taking medication, but drowsiness follows, making it hard to focus on the exam. On the other hand, if Kim avoids medication to concentrate, the fear is that sneezing and a runny nose will disrupt the exam atmosphere.

Like Kim, a high proportion of young adults in their 20s have experienced allergic rhinitis. According to the 2020 Korea National Health and Nutrition Examination Survey, among adults diagnosed with allergic rhinitis by a doctor, 31.6% of women in their 20s had the condition?the highest rate among all age groups. For men, those in their 30s had the highest rate at 20.2%, followed by those in their 20s at 19.3%.

Allergic rhinitis is a condition accompanied by symptoms such as sneezing, clear nasal discharge, and itching around the eyes and nose. The cause of these symptoms is 'histamine.' The body produces specific antibodies in response to pollen, mold, and other allergens; these antibodies bind to mast cells, triggering the release of histamine. Histamine dilates blood vessels and causes symptoms like a runny nose associated with allergic rhinitis.

Therefore, antihistamines, which inhibit the action of histamine, are mainly used as treatment for rhinitis. The drowsiness Kim complained of is a common side effect of antihistamines. This is why special caution is advised when taking antihistamines during tasks requiring concentration, such as driving or operating precision machinery.

Antihistamines are divided into first-generation and second-generation types, with the latter designed to reduce drowsiness side effects. Second-generation antihistamines like cetirizine and loratadine have little to no ability to cross the blood-brain barrier, minimizing central nervous system effects. First-generation antihistamines, such as chlorpheniramine, clemastine, and doxylamine, are absorbed and act quickly but have shorter durations of effect and cause prolonged central nervous system effects like drowsiness compared to second-generation drugs. However, even second-generation antihistamines can cause drowsiness in some cases, so caution is necessary during activities requiring special focus, such as driving.

Other treatments for allergic rhinitis include environmental therapy and immunotherapy. Environmental therapy involves avoiding allergens that trigger allergies. Common allergens include pollen, pet hair and dander, dust mites, and mold. On days when pollen is high, wearing a mask outdoors or avoiding going out is recommended, and washing bedding in hot water once a week to remove dust mites is part of environmental therapy.

If medication and environmental therapy are insufficient, immunotherapy may be used. Immunotherapy involves administering the causative allergen directly to the patient to induce tolerance. Currently, there are injection immunotherapy and sublingual immunotherapy, where high-concentration allergen extracts are held under the tongue.