Oral antihistamines are classified into two groups: first-generation (sedating) and second-generation (non-sedating) antihistamines. Both generally have equivalent efficacy with regard to symptom relief in allergic rhinitis, but their side-effect profiles differ significantly.
A study concluded that first-generation antihistamines « can negatively affect mood, sleepiness, alertness, and cognitive and psychomotor function in adults and children1 ». As a result, these antihistamines can interfere with performance and safety, even when taken the night before.
Newer second-generation antihistamines, such as Claritin®, have the benefit of being non-drowsy and have a longer duration of action than first-generation antihistamines. Therefore, it is not surprising that many experts2 recommend non-drowsy antihistamines over first-generation antihistamines for the management of allergic rhinitis.
1 Gary, KAY, The effects of antihistamines on cognition and performance. Journal of Allergy and Clinical Immunology, Volume 105, Issue 6, Pages 622 – 627.
2 T. CASALE, et al. First do no harm: Managing antihistamine impairment in patients with allergic rhinitis, The Antihistamine Impairment Roundtable Journal of Allergy and Clinical Immunology, Volume 111, Issue 5, Pages S835 – S842.