If home remedies and deep house cleaning aren't sufficient to treat or control your allergies, your doctor may be able to offer you some additional treatments.

Antihistamines. If over-the-counter (OTC) products aren't adequate, your doctor can prescribe others. For more, read my entry on antihistamines and sinusitis relief.

Cough medicines. When OTC cough drops and dextromethorphan still leave you coughing, ask your doctor if a prescription for benzonotate is appropriate. Codeine is probably the most powerful cough suppressant, but it's also a narcotic and so should be used with caution and only when necessary.

Nasal steroid sprays. Nasal steroids can be very effective for allergies, but many people don't experience their full benefit because they don't understand how these sprays work. Steroids blunt the immune response to whatever is causing the allergy. By blocking the body's initial reaction to the allergen, steroids reduce histamine production. Less histamine in turn results in less mucus being secreted into the nose and sinuses.

All this is to say that these medications are meant to prevent future mucus production; they will not clear out any of your current congestion (although the moisturizing effect might provide some relief). This means, first, that nasal steroids are unlikely to make much difference when you first start taking them and, second, they may not effectively reduce the allergic response (and annoying symptoms) if you use them only intermittently.

So should you use steroid sprays every day? Consistent daily use of one of these drugs, at least during the allergy season, can make you feel like a new person. And, although steroids can have severe side effects, delivering them directly into the nose and sinuses minimizes their effect on the rest of the body, making them a safe treatment for most people. The most common complaints are irritation of the nasal passages and nosebleeds, which can sometimes be reduced by aiming the spray towards the outer side of the nostril's airway rather than straight down the middle. You may need to try several nasal steroid brands before you find one you like.

Leukotriene blockers. These work by blocking one of the steps in the complex allergic immune response. Like steroids, leukotriene blockers are preventive medications, meant to be used daily. They can be combined with both steroids and antihistamines because these three remedies each blocks allergies in a different way. The most commonly used leukotriene blocker is montelukast (Singulair®). Side effects of these medications can include tremor, anxiety, and mood or behavior changes.

The FDA is also investigating recent reports of suicidal thinking with these drugs, but there is no clear association at this point. As with all medications, it is important to watch for these and other potential side effects, and to work with your doctor to determine if it is appropriate to start, continue, or stop one of these drugs in your specific case.

As with most medical conditions, prescription therapy offers the possibility of improved symptom control, but also brings higher costs and more potential side effects. Since environmental allergies generally don't pose a significant risk of death or major illness, you and your doctor together should decide if any of these medications is right for you.