The older generation of H1-antihistamines that are used as allergy medicines may be dangerous to people's health, says a new report published in the journal Allergy. Compiled by experts from the EU-funded Global Allergy and Asthma European Network (GA2LEN) and the European Academy of Allergy and Clinical Immunology (EAACI), the report questions whether H1 antihistamines should still be available over the counter.
The report says the first-generation H1 antihistamines - the most common treatment for conditions such as allergic rhinitis - that are currently available as over-the-counter drugs in pharmacies, have been linked with numerous health and social problems.
Compared to the newer H1 antihistamines, the older drugs come off worse, according to the report. They are linked with myriad problems: poor sleep patterns; reduced work performance and learning ability; aviation, car and boating accidents caused by drowsiness; and even death as a result of accidental overdose in children and infants, and suicides in teenagers and adults.
With more than 30% of the EU and US population being users or potential users of H1 antihistamines, the report ultimately questions whether it is in the interest of public safety that they remain available as over-the-counter allergy medication.
H1 antihistamines have been used for more than 50 years to treat allergies including allergic rhinitis (inflammation of the nasal membranes, commonly known as hay fever), urticaria (hives) and atopic dermatitis (eczema). They are usually categorised as first and second generation: the former have a more sedative effect leading to drowsiness, but this side effect is significantly reduced in the latter.
An allergy is a powerful immune response to an antigen (allergen). Allergens themselves are often harmless substances and include dust mites, pollen or animal dander (small scales shed from animal or human skin or hair). Allergic reactions occur when some people have an exaggerated reaction to an allergen which causes responses ranging from mild (e.g. running eyes and nose) to serious (e.g. anaphylactic shock).
The report says that the new generation of antihistamines have shown much reliability and efficacy in treating allergies, and patients taking them have reported far fewer side effects.
GA2LEN is an EU-funded Network of Excellence which received EUR 14.4 million under the 'Food quality and safety' Thematic area of the Sixth Framework Programme (FP6). The GA2LEN network includes partners from 26 EU-based research institutes including the EACCI and the European Federation of Allergy Patients Associations (EFA). The network carries out multidisciplinary research into all aspects of allergic diseases with the aim of improving scientific understanding of the mechanisms of allergies and of harmonising European allergy research.
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