I am wondering what antidepressants are helpful and not hurtful to people with MCAS? A doc suggested REMRON to me...I beleive it has an antihistamine in it. Thanks. Debbie

Antidepressants are very tricky for us, not because they cause us to react, but more because they interfere with the use of serotonin in our bodies.   Some of us have very low levels of serotonin and most of these meds are what are called Selective Serotonin Reuptake Inhibitors (SSRIs) and they interfere with your levels of serotonin throughout your body.  

Now, there has been only one study, that I am aware of, which has proven that some masto patients have extremely low levels of serotonin.  They don´t know why.  However, these patients seemed to be more symptomatic that those who had more normal levels.   By hyjacking the little that a patient with low levels has and forcing them to be only in the brain, your body ends up getting more deprived, at least this is what my doctors have explained to me for I too have rock bottom levels of serotonin.    When my doctor put me on Doxepin, it totally backfired on me and exacerbated my reactions and knocked me out to the point I was sleeping about 20 hours a day!!!   It also attacked my kidneys and I went into a crisis of pain after only a week and my nephrologist is who took me off the medication!!

My oncologist is who told me that this medication is contraindicated for me.   He is a specialist in neuroendocrine tumors, the carcinoid tumor to be specific, and in carcinoids tumors there is an overabundance of sertotonin being secreted in the bloodstream and so he fully understands the issues regarding serotonin and their effects upon the body and after he read this report, he informed me that these meds can´t be used in my case and I would presume that to be the same for anyone who has low levels of serotonin.  

Doxepin was not the only SSRI I´ve had adverse reactions to, however.  Revotril is a popular anti-depressant here in Brazil and the ER doctors just love to give it to people who come in thinking that by calming them down things will improve (typical).  Each time I´ve been given this medication, I´ve gotten urticaria and diarrhea and a doctor who has been totally flabbergasted upon seeing the reaction!!   So, in reacting to this SSRI, it confirms my doctor´s statement that these meds can and do backfire on some of us.

So, before your doctor prescribes an SSRI for you, ask him to also have a test checking for blood serotonin levels.  If they are normal or high then you should be able to tolerate the antidepressants.

I hope this helps.


Lisa

Debbie,
I was taking wellbutrin before I was on my mast cell stablizers. I got to the point that I was having bad reactions to it.  So I had to stop taking it.  The doc put me on a very low dose of effexor (this is the worst antidepressant to get off of) I found that this made my body hurt.  So I am now not on any and I think I would benefit from something.  So if you find something works for you please let me know.  Interestingly enough I am less depressed since I have started cromolyn.  It seems like it has helped stablize my emotions.  When I started the effexor I really needed it. I was really depressed and it did help, but I didn't like the body aches. Now I feel better, but have days where I think I need an antideppesant, but I  don't know what to take!
Pam

great question deb.  I take 30mg prozac, which is the oldest SSRI. It works for me. Am still trying to narrow down a trigger for dizziness, weird feelings in my eyeballs, and fatigue. After reading these post - I guess it could be the 'zac. However - for me, a slight reaction is better than eating a bullet.  May ttry other things in the future but right now - it is effective.