Nonsedating Antihistamines Should Be Preferred over Sedating Antihistamines in Patients Who Drive
Authors: Sean Hennessy, Brian L. Strom
Journal: Annals of Internal Medicine (2000)

Editorials7 March 2000Nonsedating Antihistamines Should Be Preferred over Sedating Antihistamines in Patients Who DriveSean Hennessy, PharmD, MSCE and Brian L. Strom, MD, MPHSean Hennessy, PharmD, MSCEUniversity of Pennsylvania School of Medicine; Philadelphia, PA 19104-6021 (Hennessy)University of Pennsylvania School of Medicine; Philadelphia, PA 19104-6021 (Strom)Search for more papers by this author and Brian L. Strom, MD, MPHUniversity of Pennsylvania School of Medicine; Philadelphia, PA 19104-6021 (Hennessy)University of Pennsylvania School of Medicine; Philadelphia, PA 19104-6021 (Strom)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-5-200003070-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Allergic rhinitis is very common, affecting approximately 16% of the U.S. population (1). Although therapy with intranasal corticosteroids and intranasal cromolyn has gained acceptance in recent years (2), antihistamines (H1-receptor antagonists) remain the first-line treatment. The possible differential effects of sedating compared with nonsedating antihistamines on driving performance and the risk for motor vehicle crashes represent an important consideration in choosing between the two categories of agents in patients who drive.In this issue, Weiler and colleagues (3) report on a study in which they used a driving simulator to compare the effects of various agents on measures of driving ...References1. Malone DC, Lawson KA, Smith DH, Arrighi HM, Battista C. A cost of illness study of allergic rhinitis in the United States. J Allergy Clin Immunol. 1997;99:22-7. MedlineGoogle Scholar2. Dykewicz MS, Fineman S, Skoner DP, Nicklas R, Lee R, Blessing-Moore J, et al . Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology. Ann Allergy Asthma Immunol. 1998;81:478-518. CrossrefMedlineGoogle Scholar3. Weiler JM, Bloomfield JR, Woodworth GG, Grant AR, Layton TA, Brown TL, et al . Effects of fexofenadine, diphenhydramine, and alcohol on driving performance. A randomized, placebo-controlled trial in the Iowa Driving Simulator. Ann Intern Med. 2000;132:354-63. LinkGoogle Scholar4. Adelsberg BR. Sedation and performance issues in the treatment of allergic conditions. Arch Intern Med. 1997;157:494-500. CrossrefMedlineGoogle Scholar5. Gengo FM, Manning C. A review of the effects of antihistamines on mental processes related to automobile driving. J Allergy Clin Immunol. 1990;86:1034-9. CrossrefMedlineGoogle Scholar6. O'Hanlon JF. Antihistamines and driving safety. Cutis. 1988;42:10-3. MedlineGoogle Scholar7. O'Hanlon JF, Ramaekers JG. Antihistamine effects on actual driving performance in a standard test: a summary of Dutch experience, 1989-94. Allergy. 1995;50:234-42. CrossrefMedlineGoogle Scholar8. Passalacqua G, Scordamaglia A, Ruffoni S, Parodi MN, Canonica GW. Sedation from H1 antagonists: evaluation methods and experimental results. Allergol Immunopathol Madr. 1993;21:79-83. MedlineGoogle Scholar9. Ramaekers JG. Behavioural toxicity of medicinal drugs. Practical consequences, incidence, management and avoidance. Drug Saf. 1998;18:189-208. CrossrefMedlineGoogle Scholar10. Ray WA, Thapa PB, Shorr RI. Medications and the older driver. Clin Geriatr Med. 1993;9:413-38. CrossrefMedlineGoogle Scholar11. Seppala T, Linnoila M, Mattila MJ. Drugs, alcohol and driving. Drugs. 1979;17:389-408. CrossrefMedlineGoogle Scholar12. Simons FE. H1-receptor antagonists. Comparative tolerability and safety. Drug Saf. 1994;10:350-80. CrossrefMedlineGoogle Scholar13. Ray WA, Fought RL, Decker MD. Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. Am J Epidemiol. 1992;136:873-83. CrossrefMedlineGoogle Scholar14. Leveille SG, Buchner DM, Koepsell TD, McCloskey LW, Wolf ME, Wagner EH. Psychoactive medications and injurious motor vehicle collisions involving older drivers. Epidemiology. 1994;5:591-8. CrossrefMedlineGoogle Scholar15. Spaeth J, Klimek L, Mosges R. Sedation in allergic rhinitis is caused by the condition and not by antihistamine treatment. Allergy. 1996;51:893-906. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sean Hennessy, PharmD, MSCE; Brian L. Strom, MD, MPHAffiliations: University of Pennsylvania School of Medicine; Philadelphia, PA 19104-6021 (Hennessy)University of Pennsylvania School of Medicine; Philadelphia, PA 19104-6021 (Strom)Grant Support: By the National Institute on Aging (R01 AG14601).Current Author Addresses: Dr. Hennessy: University of Pennsylvania, 803 Blockley Hall, Philadelphia, PA 19104-6021.Dr. Strom: University of Pennsylvania, 823 Blockley Hall, Philadelphia, PA 19104-6021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Fexofenadine, Diphenhydramine, and Alcohol on Driving Performance John M. Weiler , John R. Bloomfield , George G. Woodworth , Angela R. Grant , Teresa A. Layton , Timothy L. Brown , David R. McKenzie , Thomas W. Baker , and Ginger S. Watson Drug Effects on Driving Performance Thomas H. Lee , Jessica Dudley , and Harold J. Demonaco Metrics Cited byDo pharmacists counsel customers about the effects of sedating antihistamines on driving skills? 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Demonaco, MSCurrent AwarenessPharmacoepidemiology 7 March 2000Volume 132, Issue 5Page: 405-407KeywordsAlcoholsAllergic rhinitisAntihistaminesCorticosteroid therapyDrugsLoratadineMotor vehicle crashesRelative riskRisk managementSedation ePublished: 15 August 2000 Issue Published: 7 March 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...