It’s almost that time of year. If you experience seasonal allergic rhinitis, the appearance of spring can bring mixed feelings. Although the gorgeous weather is exhilarating, it’s hard to enjoy it when you can’t stop sniffling and sneezing. As a treatment for allergy symptoms, many people use antihistamines to get some relief. Are antihistamines for allergy symptoms a good choice?

How do antihistamines work? One of the main chemicals responsible for causing the sneezing, itchy eyes, and runny nose of allergies is histamine. When histamine is released from cells it causes the mucous membranes lining the nose and throat to become leaky resulting in the runny nose and other annoying symptoms seen with allergic rhinitis.

Although antihistamines are quite effective for the runny nose, sneezing, and itchy eyes experienced with allergies, if congestion is your main system, a decongestant is a better choice. Antihistamines aren’t particularly effective for relieving nasal congestion. The other drawback to using antihistamines for allergy symptoms is the risk of sedation. Some of the earlier antihistamines that are still on the market cause sleepiness which can make it difficult to function or drive a car. You can prevent this problem by using a second generation antihistamine such as Claritin or Allegra. Some of the older, over-the-counter antihistamines for allergy symptoms such as Benadryl can also make the mouth dry. This is less likely to happen with second generation antihistamines.

An option that’s even better than oral antihistamines for allergy symptoms is use of an antihistamine nasal spray such as Astelin which has the added benefit of relieving nasal stuffiness. This nasal spray is available by prescription and works as well as oral antihistamines. Keep in mind that it can still cause drowsiness and some people don’t like the taste it leaves in their mouth.

Although antihistamines can be an effective option for allergy symptoms, nasal corticosteroid sprays are one of the most effective treatments available and have the advantage of not causing sedation. By reducing inflammation, they dramatically improve the symptoms of allergic rhinitis. Although side effects of nasal corticosteroid sprays are uncommon, long term use can cause damage to the nasal septum. They’ve also been associated with increases in pressure behind the eyes which could lead to glaucoma in some people. There’s also the concern that they could delay growth in children.

The bottom line? Antihistamine nasal sprays are a good first line option for allergy symptoms. If these fail to provide relief or if you don’t want to see your doctor for a prescription, a less sedating second generation antihistamine available over-the-counter such as Claritin should work well. Nasal corticosteroid sprays generally work better than antihistamines for allergy symptoms but can, rarely, have serious side effects if used long term. They’re best reserved for cases that don’t respond to antihistamine treatment.