Dr John Kruse
@drjohnkruse·16.8K subscribers·484 videos
Histamine, Pitolisant, and ADHD
Posted
June 7, 2026
Views
964
Likes
79
Comments
32
Engagement
11.51%
June 7, 2026
964
79
32
11.51%
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25:26Now PlayingMain Chapters:
Histamine is a small protein-derived chemical that plays an important role in the immune system and in the brain as a neurotransmitter and neuromodulator. In the brain histamine supports arousal/alertness, helps regulate circadian rhythms, and is involved with several executive functions and with modulating appetites, feeding, and energy levels. Conventional antihistamines block either H1 or H2 receptors and are useful for treating allergies and excess stomach acid, respectively. H3 blockers actually boost histamine, and one, pitolisant, has been approved for the treatment of narcolepsy, reducing daytime sleepiness. However two large trials of H3 blockers in adults with ADHD failed to show any benefit for treating ADHD.
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References:
Deficiency of histamine H2 receptors in parvalbumin-positive neurons leads to hyperactivity, impulsivity, and impaired attention (2025, An)
Histaminergic System Activity in the Central Nervous System: The Role in Neurodevelopmental and Neurodegenerative Disorders (2024, Szukiewicz)
Mast cell activation syndrome: An up-to-date review of literature (2024 Özdemir)
Is Histamine and Not Acetylcholine the Missing Link between ADHD and Allergies? Speer Allergic Tension Fatigue Syndrome Re-Visited (2023, Blasco-Fontecilla)
Severe scombroid poisoning and life-threatening hypotension (2021)
Histamine H3 receptor antagonists ameliorate attention deficit/hyperactivity disorder-like behavioral changes caused by neonatal habenula lesion (2018, Kim)
Increased attention-deficit/hyperactivity symptoms in atopic dermatitis are associated with history of antihistamine use (2017)
Randomized clinical study of a histamine H3 receptor antagonist for the treatment of adults with attention-deficit hyperactivity disorder (Weisler, 2012)
Randomized Controlled Study of the Histamine H3 Inverse Agonist MK-0249 in Adult Attention-Deficit/Hyperactivity Disorder (2012, Michelson)
Full Chapter list:
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Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions.
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