An Ontario health specialist says she has had some of her patients ask her about a TikTok trend involving two over-the-counter medications for relief from anxiety, mood swings and other symptoms of PMDD and menopause. But Dr. Alison Shea, menopause and reproductive health specialist, remains skeptical.
PMDD (premenstrual dysphoric disorder) is a chronic condition that causes severe emotional and physical symptoms in the weeks leading up to menstruation. Both menopause and PMDD are linked to changes in mood and sleep patterns, as well as headaches and bloating.
The viral remedy involves taking a Pepcid, commonly used for relief from heartburn and acid reflux, alongside Allegra, a seasonal allergy medication.
Both medications are antihistamines, with Pepcid targeting histamine one (H1) and Allegra histamine two (H2). The unsubstantiated theory behind the trend is that the sex hormone estrogen interacts with immune cells that release histamine, potentially contributing to some symptoms. Antihistamines, social media users argue, may help counteract this effect.
“Symptoms associated with a higher histamine can be more bloating, more congestion, some skin flushing, headaches and insomnia, as well as brain fog,” Dr. Alison Shea told National Post. “But whether it’s involved in anxiety or stress is not a solid connection that’s been made.”
Nevertheless, TikTok users who’ve tried the Pecid-Allegra combination are convinced it’s had a positive impact on their mental health.
One user, @danieladiaries1, shared her experience, saying: “I’ve noticed that I’m not going into my anxiety rages, I’m noticing my anxiety is better. I don’t feel as bloated, I don’t feel as lethargic, I just feel like myself.”
Daniela said she had been taking Pepcid and Allegra for five days “to help with ovulation and PMS during perimenopause.”
Another user, @lyssawulf47, said in a video praising the viral remedy: “I already take 20mg of Lexapro and that really wasn’t cutting it…but I’m sitting in stop-go traffic right now for like 30 minutes and I don’t care.”
Dr. Shea said some of her own patients have also reported positive effects, though these tend to be related to physical symptoms such as bloating or nasal drips.
“Some of them will say they feel better. But I think that if you’re physically feeling better, that’s going to trickle down to you sleeping better, and you feeling better overall,” she said.
Dr. Michelle Jacobson, co-founder and medical director of Coven Women’s Health, is also skeptical.
She told National Post in an email that while some women notice allergy medications help with symptoms like hot flashes or poor sleep, “Antihistamines are not a true treatment for menopause. They don’t address the underlying hormonal changes, and the evidence that they reliably help is limited.”
Nevertheless, medical experts say there are few health risks associated with taking Pepcid and Allegra together.
Combining over-the-counter drugs based on social media trends is, of course, not standard medical practice. But, as long as the two drugs don’t interact with other medications being taken, Dr. Shea said that there’s no reason why patients shouldn’t try it — after consulting with a pharmacist.
“At the end of the day, if patients ask me about it, I would say it’s worth a try. Particularly if they’re having some of these more physical symptoms. They’re pretty safe medications without a lot of side effects.”
This is partly because Allegra is a non-drowsy antihistamine. She warns that drowsy medications, like Benadryl, do come with safety considerations.
Dr. Jacobson explained that taking these can “cause next-day grogginess, memory issues, dry mouth, constipation, and may increase fall risk, especially if used regularly.”
They can also interact with other medications and alcohol, she added.
Previous research published in the Journal of Psychosomatic Research found that famotidine (commonly sold as Pepcid) may help treat depression and anxiety symptoms induced by COVID-19. But there is very little research on antihistamines and hormonal changes, despite menopause affecting 50% of the population and roughly one in 20 women experiencing PMDD.
“Women’s health research has been largely underfunded for years, and this is a major problem,” said Dr. Shea. “Only 10 to 15% of research funding is focused on women’s health specifically. It’s starting to get better, slowly, but this is a large, systemic, historical problem.”
This gap may help explain why some patients turn to social media for advice, and Dr. Shea hopes that the more we hear about these trends, the more likely it is that these topics will lead to scientific research.
However, for those struggling with PMDD and menopause symptoms, she recommends trying a low-histamine diet before jumping on the Pepcid-Allegra trend.
“If you’re noticing changes in your body that could be potentially related to histamine, it’s best to do an elimination diet and cut out high histamine foods,” she said. “Then, slowly add them back in, and you can see what might be making your symptoms worse.”
Foods higher in histamine include smoked meats, aged cheeses, alcohol, fermented foods, tomatoes, and legumes.
“We’ve heard everybody wants to use a pill,” Dr. Shea said, “But we forget about all the lifestyle things that we can do, which are even better.”