What is the most effective treatment for a patient with seasonal allergic rhinitis?

Fluticasone propionate, which is a nasal corticosteroid, is considered the most effective treatment for seasonal allergic rhinitis. This is due to its ability to directly reduce inflammation in the nasal passages, leading to significant alleviation of symptoms such as nasal congestion, sneezing, and itching. Nasal corticosteroids work by inhibiting the release of inflammatory mediators from mast cells and other immune cells, which is a key feature in allergic responses.

In contrast, while other medications such as levocetirizine and montelukast can be helpful in managing symptoms, they typically do not provide the same level of overall control as nasal corticosteroids. Levocetirizine is an antihistamine that effectively alleviates sneezing and itching but may not adequately address nasal congestion. Montelukast acts as a leukotriene receptor antagonist and may provide some benefit in allergic rhinitis, but it’s generally less effective than nasal corticosteroids. Diphenhydramine, although effective as an antihistamine, can cause sedation and is not as well tolerated for daily use, especially in a condition that requires ongoing management, making it less suitable for long-term treatment of seasonal allergic rhinitis.

Thus, fluticasone