Discovering this histamine link was a very critical part of my healing journey and it ushered in a time of more rapid improvements once I started tending to it. Here Dr. David Healy supports what some of us have found in his antidepressant withdrawal guide. (it should be noted that this information is relevant to folks who have taken other psych meds as well as most of them impact histamine)
Before sharing the excerpt I’d like to emphasize that there are natural ways to stabilize mast cells and lower histamine. If it’s possible to avoid the pharmaceuticals he’s recommending, it seems to have preferable outcomes in the long run for people who are most heavily impacted by hypersensitivity issues.
“Having said this, SRI dependence and withdrawal does involve real bowel disturbances from diarrhea through to food intolerance that are difficult to see just as a vigilance problem and there is much more serotonin in the gut and muscles than anywhere else.
Stabilizing the histamine system
The SRIs are a group of antihistamine drugs that also inhibit serotonin reuptake. Despite marketing propaganda, they are not selective or clean drugs.
One way to manage withdrawal might be to switch to an SRI antihistamine such as chlorphenamine or diphenhydramine. These are less potent SRIs and switching to them is a way to slowly reduce the dose.
A related option here is to switch to a tricyclic antidepressant such as dosulepin which is also an antihistamine with less potent serotonin reuptake inhibiting properties.
The best way to think about this is that the SSRIs are like sports cars that can pick up pace incredibly quickly but a car like this isn’t needed in a town or a city. The amount of serotonin and reuptake inhibition from dosulepin or chlorphenamine is all that is really needed for most situations.
There are other antihistamines that do not inhibit serotonin reuptake such as loratadine or cetirizine that might be useful if withdrawal comes more from histamine than serotonin.
Stabilizing the histamine system – 2 A further option on the antihistamine front is to view serotonin withdrawal as a histamine over-activity (semi- allergic) state brought around by the fact that the person has been on antihistamines chronically.
One of the ways to damp down histamine over activity is to use a mast cell stabiliser such as sodium chromoglycate. Sodium chromoglycate (Nalcrom) is used extensively for people with food intolerance – a complaint that many people with SRI withdrawal have.
The histamine system can be further damped by adding a H2 receptor blocker such as cimetidine or ranitidine. Cinnarizine is an antihistamine that is also a calcium channel blocker.” (
the whole withdrawal guide is here) (UPDATE 2017 — NEW LOCATION OF THE GUIDE HERE)
I don’t know if Dr. Heally has understood the potential extent of histamine issues as some of us have seen it among those of us hit hardest by protracted psych drug withdrawal issues (and therefore, again, I do not necessarily recommend, in any general way, the drugs he suggests as a lot of us become intolerant of them as well and can have really nasty reactions to them). Still these comments on histamine issues during SSRI withdrawal are interesting and serve as important validation as well, really, in a world where we are rarely believed, but doctors are.
The fact is that some people with protracted issues from psych drug withdrawal, also have severe and long-term issues with histamine intolerance. Furthermore, it seems pretty clear among those folks that for a good number of them, the histamine intolerance predates psych drug use. The psychiatric drugs just exacerbate the issue. Psych drugs may have, in fact, seemed effective for some time due, at least in part, to their anti-histamine mechanisms which may have brought some relief when first using a psych drug.
So yes, some of us have very serious and lasting histamine and mast cell dysregulation issues. This is a part of the global hypersensitivity we see in folks coming off these drugs (and not just SSRIs and antidepressants but all psych meds do this more or less). See: Limbic Kindling — hardwiring the brain for hypersensitivity for more general info about these sorts of phenomena
Those of us who’ve had significant healing from these long-lasting issues have found it’s best to avoid pharmaceuticals that people might use to manage the histamine issues. (at least in the long run that often seems to be the case…, some short-term use may be indicated at times and that simply needs to be determined on an individual basis) Long-term use seems to halt long-lasting healing quite often and people also get dependent on them. I would say that in times of crisis, they may certainly be appropriate, briefly, just like psych meds should be used ideally.
Rather than using pharmaceuticals to calm down the system, changing diet and lifestyle by including natural antihistamine foods and herbs seems to be what brings about long term healing. Mind/body practices including meditation and movement, too, seem critically important among those of us who start to turn around this particular form of sensitivity. In time we are able to eat more and more foods again and the extreme hypersensitivity begins to heal.
David Healy’s manual actually suggests a lot of alternate drug use while coming off of psych meds. While this sort of easing off drugs with others drugs may on occasion be called for, it also can often exacerbate folks who are having issues with a lot of hypersensitivities. So it’s a problematic way to go about supporting folks and isn’t necessary as often as doctors might assume. They tend to continue to like prescribing even when they acknowledge that drugs can harm. It’s what they’re familiar with.
On our withdrawal boards we see people harmed in this way over and over again by well-meaning doctors who’ve not seen the likes of us who’ve become most hypersensitive. I did, personally, use small (micro) amounts of various drugs for the first couple of years in order to avoid complete crisis, but I had people helping me who allowed me to make all the calls after a certain point. Before that I had doctors harm me repeatedly. And the key was learning that tiny fractions of what is considered a therapeutic dose was all that was needed most of the time. I also no longer tolerate even in tiny doses the very few drugs that briefly helped me during some hard times. I don’t make absolute statements about how people get through the darkest times of their lives. We do whatever we need to do. I simply want to caution folks because it’s really tricky to use drugs to come off drugs and I can tell you almost every drug Healy recommends were really drastically nasty for me (and I know others too, like me) and when I found drugs that helped I used such tiny amounts that most doctors wouldn’t believe it was actually doing anything. I was lucky to have a doctor who understood the hypersensitivity in a profound way during that time. So, again, just be aware and trust your body over and above a prescribing doctor. Your doctor should be doing that as well.
That was a bit of a digression about the manual in general. Back to the histamine issue… People can find themselves in antihistamine dependency if they start to take them because histamine intolerance can be extremely difficult to deal with and long-term use of antihistamines seem to make it more likely to get protracted. That is not made clear the manual either.
I personally do not tolerate anti-histamines, or most pharmaceuticals, for that matter, at this point and find that for long-term healing and well-being they are simply best avoided when at all possible. In fact, in my histamine intolerance circles many people don’t tolerate pharmaceuticals in general as well, much like me, and most of these folks do not have my psych drug history or any significant history of psychiatric drug use. Histamine intolerance and associated sensitivities are simply another one of these issues we find in a lot of chronic illness, including psych drug withdrawal syndromes (not just associated with antidepressants, but other classes of psych drugs too).
I want to say one more thing about hypersensitivity. At this point I’ve come to deeply appreciate mine as it demanded I learn to listen to my body intently. Now the hypersensitivity works for me in that since I’ve been paying close attention for several years I’ve learned what my body needs and when it needs it. So really it’s been guiding me on how to heal and I no longer run into nearly as much reactivity. I mostly see being sensitive like this as a good thing now — as I continue to develop my understanding I heal more and the limitations continue to diminish. In large part the hypersensitivity was simply my body screaming at me to pay attention! Now that I do, we’re becoming good friends.
This issue also ties into the whole autonomic nervous system instability we see among a lot of us with protracted issues and various chronic illnesses.
Go here for more general info and history on Beyond Meds: Histamine intolerance roundup. — all the posts linked to there have multiple links to other resources to get you started
Histamine intolerance roundup is not an exhaustive source of information. I have learned a lot since I’ve last shared information. Please do research and follow links and info resources I’ve shared to learn more. Discovering this histamine link was a very critical part of my healing journey and it ushered in a time of greater healing once I started tending to it.
I want to thank Yasmina Ykelenstam at The Low Histamine Chef who has tirelessly shared her research and own recovery process from a mast cell disorder and histamine intolerance. While, it’s true, we are all profoundly different her recovery and research has repeatedly informed and inspired my own healing process. In spite of having very different needs at times (and I point this out only so that people understand that I have by no means simply copied exactly what she has done — that doesn’t work — my body has had it’s own requirements and needs that are sometimes quite different from what Yasmina has needed) still her methodology and ongoing optimism has helped me learn and grow in countless ways. I suggest that anyone struggling with a histamine issue or a mast cell disorder seek out her work for both quality information and inspiration as well. The Low Histamine Chef
Update 2016: Histamine issues are only a piece of the vast holistic puzzle that the drug injury left me with. The histamine link serves as one possible window to access the chaos that has been my injured nervous system. It was a very helpful window for a couple of years. It’s not the window I prefer or use primarily anymore, though the information I gleaned from using this framework moved me along in my healing in significant ways. I prefer to now use more holistic understandings of body/mind/spirit. Histamine is one tiny molecule in our bodies interacting with millions of other microorganisms and chemicals in our bodies. It really doesn’t need to be given such prominence in the long run. Lately I prefer to use Chinese and Ayurvedic medicine to understand the intense complexity that is our human body . Still, the above info on histamine may be very helpful if this is what is currently resonating for you.
*it is potentially dangerous to come off medications without careful planning. Please be sure to be well educated before undertaking any sort of discontinuation of medications. If your MD agrees to help you do so, do not assume they know how to do it well even if they claim to have experience. They are generally not trained in discontinuation and may not know how to recognize withdrawal issues. A lot of withdrawal issues are misdiagnosed to be psychiatric problems. This is why it’s good to educate oneself and find a doctor who is willing to learn with you as your partner in care. Really all doctors should always be willing to do this as we are all individuals and need to be treated as such. See: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up
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