Rhinitis medicamentosa: "Confessions of a Nasal Spray Addict"

From The Island Med Student blog:

"Let me go back to the beginning. Several months ago, I became very sick, and one of the worst symptoms was rhinnorea (runny nose) and congestion. It was absolutely horrible, and I could barely breathe. Since I can’t take oral pseudoephedrine (makes me jittery and hallucinate), I decided to use the OTC nasal sprays available. After 2 quick squirts, my life was turned around! I could breathe effortlessly. My head wasn’t pounding and feeling like it was going to explode. All was well again!

However, now it’s been several months, and I can’t seem to get off the nasal spray. If I stop using it, my nose completely swells up with mucous. I can’t breathe at ALL through my nose. My head feels like it’s going to explode. My ears start popping painfully.

So, I started doing some research online, and it turns out that I am not alone. Millions of people suffer from nasal spray addiction, or “Rhinitis medicamentosa.”

The topical use of decongestant sprays leads to rebound hyperemia, producing progressively worse nasal obstruction and "rhinitis medicamentosa."

Although the most common agents implicated in "rhinitis medicamentosa" are topical decongestants, oral medications may also play a role, especially beta-blockers, clonidine, ACEi, and oral contraceptives.


Afrin - Costco.


Rhinitis types, pathological classification.

References:
Confessions of a Nasal Spray Addict. The Island Med Student, 2009.
Allergic Rhinitis: A Short Review

Pseudoephedrine used in allergic rhinitis improved stuffy nose but decreased sexual activity http://goo.gl/1uLxb

Oxymetazoline for 1 month adds to nasal steroid effect in perennial allergic rhinitis, without development of rhinitis medicamentosa. JACI, 2011.
WVU Health Report - Nasal Spray Addiction, 2011 (video).
Image source: Oxymetazoline, the active component of Afrin nasal spray, Wikipedia, public domain.