Montelukast: a better alternative than antihistaminics in allergic rhinitis

Abstract

Background: Allergic rhinitis is associated with sleep disturbances, daytime somnolence, and fatigue. Hence, present study was undertaken to evaluate and compare the nocturnal symptoms such difficulty in going to sleep, night time awakening and nasal congestion/obstruction on awakening among allergic rhinitis patients after administration of montelukast, chlorpheniramine meleate, levocetrizine, desloratidine and fexofenadine and to find out anti-allergic drug with maximum improvement in total symptom complex score.

Methods: The present study comprised of 125 patients suffering from allergic rhinitis on the basis of characteristic history, corroborative physical findings and blood eosinophilia. Night times symptoms including difficulty in going to sleep, night time awakenings and nasal congestion on awakening were evaluated after patients were given oral treatment with chlorpheniramine maleate, levocetrizine, fexofenadine, desloratadine and montelukast for a period of 6 weeks in different 5 groups and the result interpreted on the basis of symptoms relieved. Symptoms were recorded on day 1, 2 weeks, 4 weeks and 6 weeks of treatment and analysed. All the patients were randomly divided into five groups of 25 each. The results were tabulated and analyzed by chi-square, Kruskal-Wallis test.  

Results: The present study found that levocetirizine provided immediate effect at 2 weeks which is significantly better than other drugs. But at 6 weeks, montelukast is best among the drugs which were compared; followed by levocetrizine, fexofenadine, and desloratadine and chlorpheniramine maleate.  Montelukast was found to be a better drug as it has no significant side effects. Desloratadine group had dryness of mouth. Chlorpheniramine maleate has maximum side effects. 6 patients who took chlorpheniramine maleate complained of sedation, 1 patient complain of psychomotor disturbance.

Conclusions: The present study concludes that in terms of clinical efficacy, safety/tolerability and improvement in night time symptom scores at six weeks therapy in allergic rhinitis, montelukast is the better drug.