A cold can make a person completely miserable. What’s worse than a stuffy head and a runny nose, along with perhaps a cough, headache, or sore throat?

Many things, of course, but when you have a cold it’s hard to think of which ones are worse. All you want is relief, and fast. Should you see a doctor?

Think for a moment about what you would like to accomplish by seeing a doctor. You probably know that colds are caused by viruses and that an antibiotic will not help a virus. Unless you have an underlying problem that predisposes you to a more serious infection, such as asthma or chronic obstructive pulmonary disease (COPD), an antibiotic won’t cure you faster. Your own body’s immune system is what cures a cold.

Since no drug will provide a true cure, what about symptom relief?

There was a time, not too many years ago, when “good” drugs were only available by prescription. Not anymore. Almost all so-called cold medicines are now available without a prescription, the same medicines that were once prescribed.

The biggest problem with treating yourself at home is knowing which medicine to use for each symptom. If congestion or stuffiness is your main symptom, what you’ll need is a decongestant to open up your airways and relieve sinus pressure. There are no stronger prescription decongestants than over-the-counter pseudoephedrine, which you’ll need to ask your pharmacist to provide. The drug is available without a prescription, but it is still kept “behind the counter”.

Some people benefit from an expectorant, which simply thins mucus so it drains more easily. Again, there is no stronger prescription drug than over-the-counter guaifenesin, which is found in Mucinex, Robitussin, and similar products.

If the problem is a runny nose or postnasal drainage, you may want to dry up the mucus with an antihistamine. Diphenhydramine (Benadryl) and chlorpheniramine are inexpensive and effective, but sometimes cause drowsiness. Cetirizine (Zyrtec), a nonsedating antihistamine, is another option. Loratadine (Claritin) works well for drying out allergic noses, but is not as effective for colds. Again, all of these drugs were prescribed just a few years ago and are as good as any drugs a doctor can prescribe.

Over-the-counter pain relievers, such as acetaminophen and ibuprofen, can relieve sore throat and sinus pain associated with a cold. Doctors will not prescribe anything stronger for your discomfort. Aspirin also works well, but is more likely to cause stomach upset and should not be used in children under 18 due to the higher incidence of Reye’s syndrome.

Dextromethorphan, found in many over-the-counter cold preparations, is an effective cough suppressant. The only thing stronger is a narcotic, which you’d have to get from a doctor, who would probably suggest he try the over-the-counter dextromethorphan first anyway.

So we’ve covered congestion, drainage, cough, sore throat, and pain. What’s left? Chest symptoms, maybe, but that’s more than just a cold. If you have a chest cold, it’s probably best to see your doctor.

Finally, if a cold persists for more than 10 days, a secondary infection may have occurred, for which an antibiotic may be recommended.

But in general, if you’re not too sick to work or go to school, you probably don’t need to see a doctor. Give your body some time to heal itself.

Copyright 2010 Cynthia J. Koelker, MD