Nonpharmacologic therapies to treat allergies

[Kanish]

Hi, my aunt Rupsha is a 45-year-old woman who comes to the pharmacy in August complaining of itchy eyes, frequent sneezing, and runny nose. She plays in a softball league with all her friends and loves it. She says that 2 years prior, she was very depressed and on multiple antidepressants. Since she joined the softball league, her physician has discontinued her depression medications and she is feeling wonderful. She now feels like she is part of a team and thinks of her teammates as part of her family. Now that her symptoms are getting worse, she has been unable to participate in the activities she wants to on a daily basis. She claims she wants to relieve her symptoms, but she is opposed to taking any medications because she believes that all medications are eventually associated with an increased risk of heart attack. She wants to know if there are any nonpharmacologic therapies that would help relieve her symptoms so she can start playing softball again.

[anwesha]

@Kanish Rupsha would be a candidate for self-treatment of seasonal allergies. She can use any of the second-generation antihistamines. However, since she is not keen on using pharmacologic therapy, it may be appropriate to help her control her symptoms through education. It may be beneficial to tell her to stay indoors and avoid playing softball when the pollen count is high and when most patients have symptoms. However, since she says taking part in the softball league has helped decrease her depression, it would be inappropriate to advise her to stay indoors all the time. Nasal wetting agents such as saline may be beneficial for Rupsha as a means to relieve nasal mucosal dryness, thus decreasing nasal stuffiness, rhinorrhea, and sneezing. If her symptoms continue to worsen, she may have to weigh the risks and benefits of taking medication and also consider whether she wants to continue to play softball.