|
Update 2-21-2007 (Summary of article): So far, the most effective treatment for relieving your nasal spray withdrawl symptoms (e.g. stuffiness) appears to be a dose of prednisone along with antibiodic. This is just from what I gather from the feedback I receive and the comments below. You will need to see an ear, nose and throat (ENT) doctor to get this prescription. The best non-prescription solution appears to be the usage of a humidifier with a drop of Vicks Vapo Steam added to the water. Please leave a comment below about your nasal spray withdrawl horrors; it only serves to help others to know that they are not alone. Or at least read some of the stories that other readers have shared; you won’t want to use Afrin ever again!
|
Before an intervention is called, I will go ahead and openly admit that I have a problem. I am addicted to over the counter nasal spray. Not because I have a killer sinus problem but because every time I fall off the wagon, the congestion returns with vengeance, blocking my nasal passages, stifling my sleep, and overall, decreasing my quality of life.
Summarizing from last weeks Grey’s Anatomy, the medical term of my condition is Rhinitis Medicamentosa. This is quite different from Allergic Rhinitis for the onset of my condition is caused by the continuous usage of OTC nasal sprays, as opposed to Allergic Rhinitis, which is a blockage of the nasal passage due to a common allergen. Most of OTC nasal sprays use one of two main ingredients; Oxymetazoline or Phenylepherine. Oxymetazoline is the most common active ingredient (as found in Afrin) while Phenylepherine comes in second (as found in 4-Way Nasal Spray). Either of these ingredients work by temporarily shrinking the nasal membrane. Both are very effective. Both are very addictive.
My Story
My troubles started back in early May. I had begun an intensive weight training program and had been making good progress towards eliminating body fat while gaining muscle and strength.
But coupled with my intense workouts, a tight schedule at work, a flurry of "oh shit" home repairs, and ignoring my blood pressure medicine, I quickly found my head feeling like it was going to explode, and I was hospitalized soon thereafter.
Slowly through the usage of a combination of drugs, my blood pressure came back down. But I started to realize another issue; I was still receiving headaches. Not the same headache that I had experienced earlier (frequent blood pressure checks confirmed this), but more of a sinus pressured pain. The intensity would originate from the top of the nose to around the eye-brow and would work its way throughout the top of my head. It was as if someone squeezing the top of my forehead.
I was taking a combination of Atenolol, Hydralazine, and Dyazide for my blood pressure.
The pain always intensified after nasal spray usage, and would weaken as the day progressed. Usually the pain would wear off after a period of 12-13 hours. The congestion always persisted even after the headaches died down. This lead me to believe that the headaches were induced by the nasal spray.
My suspicion is the my nasal spray was interracting with my blood pressure medication. Hydralazine works by dialating the veins and nasal spray constricts the membrane tissue, so that conflict is probably what was causing my headaches. It’s no coincidence that the headaches lasted on average of 12 hours (the same amount of time most nasal sprays remains effective).
I needed to kick this habit and do it quickly.
I finally broke down and purchased the Rhinostat titration system. The premise behind a titration system is that you utilize the medication (in this case, nose spray) as needed, and when the liquid reaches a certain point in the bottle, you add a dilutent to reduce the contents of the active ingredient. The Rhinostat system appeared to work fairly well in the beginning. The bottle is a peculiar design and didn’t seem to penetrate my nasal passages the way a conventional nasal spray bottle did. The dosage of the decongestant is quite small, so if you find yourself frequently using your nasal spray, the Rhinostat system is going to become diluted quite quickly. Unfortunately the dilution of the system outpaced the withdrawal of my symptoms. In the end, I was left with a fully diluted solution and still a stuffy nose. In order to sleep, I relapsed.
I have tried several decongestant products since the Rhinostat system, and all have failed to clear my passageways. Here are the products I tried in attempt to alleviate congestion (all of the products do not contain Oxymetazoline or Phenylepherine):
- Sinusbuster
- SnoreStop NasoSpray
- Colloidal Silver Nasal Spray by Source Naturals
- Sinus and Allergy Relief Nasal Spray by bioAllers
My Own Titration System
Since I was unsuccessful in finding a solution that allowed me to sleep in peace, I decided to create my own titration system that I could control the dosages.
Start with a full bottle of nasal spray and every time the fluid level reaches half, fill in the rest of the fluid level with Saline nose spray. BUT, not just any saline nasal spray. Don’t go the cheap route on this; make sure that saline solution does not contain benzalkonium chloride (e.g. Simply Saline ). Benzalkonium chloride has been shown to further increase the rebound effect. Most cheap saline solutions WILL WORSEN your symptoms (e.g. stuffiness). If you don’t want to continue having a stuffy nose, get Simply Saline oror something without the preservatives.
Repeat this process of filling the nasal spray bottle with Simply Saline until the solution is fully diluted.
The Conclusion (as of 7/13/06)
So far, I still get somewhat congested and I can feel my sinuses swell up from time to time, but I think the intensity is slowing diminishing. I’ve heard that it takes 4-7 days to withdrawal cold-turkey, so utilizing a titration system I can reasonably expect double that time-frame before I can draw any real conclusions.
I see an otolaryngologist (ear, nose, and throat specialist) tomorrow. While I am skeptical that he’ll have any real insight besides the standard "stop using the stuff!", I’ll be sure to follow-up if he has any better solutions.
Update (8/4/06 10:11pm)
After further research, I’ve discovered that some individuals have had success with a relatively new antihistamine called Astelin that doesn’t contain any steroids, Oxymetazoline or Phenylepherine. My ear, nose and throat doctor was able to provide me a months sample.
A word of warning, Astelin is extremely bitter and even with a big gulf of mouthwash, don’t be suprised when the aftertaste remains. The substance has a sedative effect, and after a liberal dose, definitely made me sleepy. As a decongestant, it was mildly effective. My nasal passages opened up a bit, but by the time I had awakened in the morning, my stuffy nose had returned. Over usage of the medication only seemed to worsen my congestive issues. 3-4 pumps appeared to be the optimal dosage for effectiveness.
Further Updates (8/24/06 6:00pm)
Tim, author of the "Herbs and More" blog, was kind enough to further clarify his comments with an email outlining some specific herbal remedies for congestion. He writes….
" My nose would continually stop up at night. It would open at least partially during
the day, but at night, forget it! I was on Allegra and Nasalcort spray, both
prescriptions which were around $25 each per month.
Now, the only time I use an Afrin type nasal spray is right now, because I have a
bad cold. This is the 3rd day. Even so, I am only using it at night so I can
sleep. Other than that, I have not used any type of decongestant for over 9
months.
I take Stinging Nettles four times a day. The cheapest place to buy them is at
Puritan’s 3 for 1 sale. If you buy any from there, please get there through my
blog so I’ll get credit. I also take a ginger capsule four times a day with the
Stinging Nettles. I buy the Ginger at Wal-Mart…Rexall brand.
Like any herb, it can take a couple of weeks before you start having an effect.
For nasal sprays, I alternate between Nasalcrom, which is non-addicting over the
counter which you can get at Wal-mart, and Nutribiotic Grapefruit Seed Extract
nasal spray, which is the cheapest price at Vitacost. If you get anything from
Vitacost, please go there through my blog.
At first, I had to heavily use the nasalcrom or the Nutribiotic GSE nasal spray.
But the longer I took the Stinging Nettles and Ginger, the less often I use those.
I probably only use one of them about 1 day out of every two weeks. My nose
stays pretty clear, even at night, usually without them.
Good luck and I hope you find something non-prescription that works for you! One
last thing…there are expensive herbal decongestant formulas without sudaphed
that are supposed to help your nose. They are costly, even at Vitacost. I tried
all of them and for me, they did not work. The Stinging Nettles (1 bottle of 100
capsules is about $3.80 with puritans 3 for 1 sale) and the ginger (1 bottle of
100 capsules for $3.88 at Wal-mart) works for me….and it is much cheaper! "
If you like any of Tim’s suggestions, return the favor by buying your desired herbs from his site.
Update (9/10/06 10:24pm)
http://groups.google.com/group/alt.support.sinusitis/msg/c8025333cf1faae9?hl=en&
The easiest way to get off Afrin is a short course of prednisone with an
antibiotic. Ask your doctor about this.
Murray Grossan, M.D.
Anyone else have any experience with this treatment?
Update (12/9/2006 2:00pm)
If you can get a heated humidifier and add some "Vicks Vapo Steam" (http://www.walgreens.com/store/product.jsp?CATID=306484&id=prod352095) to the water, it should help a bit to open up your passages (only temporarily though). Stick your face close to the humidifier, and try to breathe in as deep as possible. Or a Vick’s Personal Steam Inhaler may be more appropriate than a general humidifier ( http://www.achooallergy.com/sinus-vicksinhaler.asp )
Update (2-22-07 8:00pm)
As if we needed any more reason to quit using OTC Nasal Sprays, I ran across this 1994 study outlining a few cases where OTC nasal spray was attributed to inducing paranoid psychosis in some patients. I can personally testify that looking back, I was clearly more hyper when utilizing the spray and would get these periods of adrenal rushes where it was nearly impossible to sit at my desk and concentrate. I no longer experience these intense hyper moments, but to be fair, I have also quit caffeine as well, so that could have been the contributing factor.
Here is a link to the study for those interested: Paranoid Psychosis Induced by Oxymetazoline Nasal Spray
Update (3-15-07 9:17pm)
Just to clarify….
From some of the emails that I receive, I think we have to make a distinction here. If you’re congestion is partly due to sinuses, alergies (pollutants, allergens, etc), cold, etc, there may be ways to reduce the congestion. You could look at using an antihistamine, Corticosteroid, cromolyn sodium, a decongestant or flush regularly with a pure saline spray.
But the above text above is addressing the issue of stufiness as it stems from the overuse of over the counter nasal/nose spray. I never had problems with sinuses and such, so it was much easier for me to isolate my problems directly with the nose spray usage. But if you have other related issues, you should look at getting those problems resolved first before discontinuing your nasal spray.
Why is that? You have to treat the process as a science experiment. For instance, if you have chronic sinus issues and have used the nasal spray heavily for several years, if you discontinue the usage of the nasal spray yet remain stuffed up, how do you know if the issue is that you’re not fully withdrawn from the nasal spray or is it just your sinuses continuing to complicate matters?
Remember to isolate the process, taking it one step at a time.
Information Links
4 Comments »