If you’re a spring or summer allergy sufferer, you’ve probably powered through your fair share of antihistamines by now. (And if it’s fall pollen that stuffs up your sinuses, perhaps you’re stocking up.) These meds block histamine—the chemical your body releases in response to allergens—bringing sweet relief from the itchy eyes, runny nose, and other miserable symptoms it triggers. But stopping the drugs isn’t always simple. For some folks, a form of antihistamine withdrawal can crop up in their absence.
The main symptom of this type of withdrawal is itching all over your body, particularly when you suddenly stop taking Zyrtec (cetirizine) or Xyzal (levocetirizine) after months of continuous use, Sheryl Mathew, MD, a board-certified allergist and immunologist at ENT and Allergy Associates Pennsylvania, tells SELF. After receiving more than 200 reports about this reaction over the past few years, the FDA issued a safety statement in May, requiring prescription versions of these drugs to include a warning and calling on manufacturers to add one to OTC options. And that number just includes the people who reported it to the agency; if Reddit is any indication, antihistamine withdrawal could be even more prevalent.
Keep reading to learn how and why allergy med withdrawal happens, and what you can do to calm the itchy response.
What does antihistamine withdrawal look like, and why does it happen?
The word “withdrawal” is a bit misleading here, as this kind of reaction “isn’t caused by becoming dependent on antihistamines in the way that we think of, say, nicotine or caffeine addiction,” Payel Gupta, MD, a Brooklyn-based board-certified allergist and immunologist and a member of the medical advisory council of the Allergy & Asthma Network, tells SELF. Instead, think about it as a boomerang response of your histamine receptors. When they’ve been restricted for so long by the antihistamines, they may essentially overcompensate by becoming ultrasensitive, Dr. Gupta explains. So when you stop the meds, they’re primed to spring into overdrive—which is what may spark the all-over itching. (Your skin is full of histamine receptors.)
That change in histamine sensitivity likely develops over time, which is why you’re more likely to experience withdrawal if you’ve been popping the meds daily for several months or years (for instance, to deal with perennial allergies to dust mites, pet dander, or mold). But as Dr. Gupta points out, allergy season has also been creeping earlier each year and extending later due to climate change, so even the seasonal sufferers might be taking antihistamines long enough to prompt withdrawal upon stopping. (And in a few cases reported to the FDA, people experienced the itchy response after less than a month of use.)
Some anecdotal reports of antihistamine withdrawal also cite insomnia, mood swings, and worsened allergy symptoms—but the only phenomenon proven to be linked to quitting the medication is the itching, Dr. Mathew says. If it seems as if your stuffy nose and watery eyes are worse post-antihistamine use than before you started, Dr. Gupta points out that you may have just forgotten how bad things actually were. These other symptoms more likely point to your underlying allergies resurfacing (which can also certainly wreck your sleep and, in turn, your mood) versus withdrawal from the meds.
How to get ahead of antihistamine withdrawal and find relief from the intense itching
If you’re in the throes of itching hell, your best bet is to restart the antihistamine for a few days at your previous cadence and then slowly taper off of it (rather than stopping suddenly), Dr. Mathews says. This is also a good approach to prevent antihistamine withdrawal: If you’re popping Zyrtec or Xyzal every day, go down to every other day for a week or two, then every third day for another couple weeks if you’re still feeling well, Dr. Gupta suggests. This way, it won’t come as a shock to your system when you ultimately cut it out.
