Indian Journal of Private Psychiatry

Register      Login

VOLUME 13 , ISSUE 2 ( July-December, 2019 ) > List of Articles

REVIEW ARTICLE

Role of Cyproheptadine in Various Psychiatric Conditions

Aritra Chakraborty

Keywords : Improving psychiatric practice, Schizophrenia,Antidepressants

Citation Information : Chakraborty A. Role of Cyproheptadine in Various Psychiatric Conditions. Ind J Priv Psychiatry 2019; 13 (2):58-61.

DOI: 10.5005/jp-journals-10067-0034

License: CC BY-NC 4.0

Published Online: 00-12-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Though cyproheptadine is commonly used for treatment of different allergic conditions, the molecule is effective in different psychiatric conditions mainly due to antiserotonin property. Cyproheptadine can be used in different psychiatric conditions like functional gastrointestinal disorders, serotonin syndrome, akathisia, tardive dyskinesia, anorexia nervosa, stimulant-induced weight loss, antidepressant induced sexual dysfunction, neuropsychiatric adverse effects associated with efavirenz therapy in HIV positive patients, migraine type headache, augmentation agent in schizophrenia. As the molecule is not very costly, its use can help in improving psychiatric practice in developing nations.


PDF Share
  1. Product Information: Periactin (R), cyproheptadine tablets and syrup prescribing information. West Point, PA: Merck & Co.; 1999.
  2. Pucci E, Petraglia F. Treatment of androgen excess in females: yesterday, today and tomorrow. Gynecol Endocrinol 1997;11(6):411–433. DOI: 10.3109/09513599709152569.
  3. Kapur S, Zipursky RB, Jones C, et al. Cyproheptadine: a potent in vivo serotonin antagonist. Am J Psychiatry 1997;154(6):884. DOI: 10.1176/ajp.154.6.884a.
  4. Takemura K, Takada K, Mameya S, et al. Regional and functional differences of 5-hydroxytryptamine-receptor subtypes in guinea pig stomach. Jpn J Pharmacol 1999;79(1):41–49. DOI: 10.1254/jjp.79.41.
  5. Nascimento Jr EB, Seniuk JG, Godin AM, et al. Peripheral 5-HT1B and 5-HT2A receptors mediate the nociceptive response induced by 5-hydroxytryptamine in mice. Pharmacol Biochem Behav 2011;99(4):598–603. DOI: 10.1016/j.pbb.2011.06.016.
  6. Rasquin A, Di Lorenzo C, Forbes D, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006;130(5):1527–1537. DOI: 10.1053/j.gastro.2005.08.063.
  7. Worawattanakul M, Rhoads JM, Lichtman SN, et al. Abdominal migraine: prophylactic treatment and follow-up. J Pediatr Gastroenterol Nutr 1999;28(1):37–40. DOI: 10.1097/00005176-199901000-00010.
  8. Rodriguez L, Diaz J, Nurko S. Safety and efficacy of cyproheptadine for treating dyspeptic symptoms in children. J Pediatr 2013;163(1):261–267. DOI: 10.1016/j.jpeds.2012.12.096.
  9. Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005;352(11):1112–1120. DOI: 10.1056/NEJMra041867. Errata in: N Engl J Med 2007;356(23):2437, N Engl J Med 2009;361(17):1714.
  10. McDaniel WW. Serotonin syndrome: early management with cyproheptadine. Ann Pharmacother 2001;35(7–8):870–873. DOI: 10.1345/aph.10203.
  11. Graudins A, Stearman A, Chan B. Treatment of the serotonin syndrome with cyproheptadine. J Emerg Med 1998;16(4):615–619. DOI: 10.1016/S0736-4679(98)00057-2.
  12. Halmi KA, Eckert E, LaDu TJ, et al. Anorexia nervosa: treatment efficacy of cyproheptadine and amitriptyline. Arch Gen Psychiatry 1986;43(2):177–181. DOI: 10.1001/archpsyc.1986.01800020087011.
  13. Johnson C, Stuckey M, Mitchell J. Psychopharmacological treatment of anorexia nervosa and bulimia: review and synthesis. J Nerv Ment Dis 1983;171(9):524–534. DOI: 10.1097/00005053-198309000-00002.
  14. Daviss WB, Scott J. A chart review of cyproheptadine for stimulant-induced weight loss. J Child Adolesc Psychopharmacol 2004;14(1): 65–73. DOI: 10.1089/104454604773840508.
  15. Aizenberg D, Zemishlany Z, Weizman A. Cyproheptadine treatment of sexual dysfunction induced by serotonin reuptake inhibitors. Clin Neuropharmacol 1995;18(4):320–324. DOI: 10.1097/00002826-199508000-00003.
  16. Decastro RM. Reversal of MAOI-induced anorgasmia with cyproheptadine. Am J Psychiatry 1985;142(6):783. DOI: 10.1176/ajp.142.6.783b.
  17. Weiss D, Aizenberg D, Hermesh H, et al. Cyproheptadine treatment in neuroleptic-induced akathisia. Br J Psychiatry 1995;167(4):483–486. DOI: 10.1192/bjp.167.4.483.
  18. Gardos G, Cole JO. Pilot study of cyproheptadine (Periactin) in tardive dyskinesia [proceedings]. Psychopharmacol Bull 1978;14(2):18–20.
  19. Friedman MJ. Drug treatment for PTSD. Answers and questions. Ann N Y Acad Sci 1997;821:359–371. DOI: 10.1111/j.1749-6632.1997.tb48292.x.
  20. Harsch HH. Cyproheptadine for recurrent nightmares. Am J Psychiatry 1986;143(11):1491–1492. DOI: 10.1176/ajp.143.11.1491.
  21. Brophy MH. Cyproheptadine for combat nightmares in post-traumatic stress disorder and dream anxiety disorder. Mil Med 1991;156(2):100–101. DOI: 10.1093/milmed/156.2.100.
  22. Gupta S, Austin R, Cali LA, et al. Nightmares treated with cyproheptadine. J Am Acad Child Adolesc Psychiatry 1998;37(6): 570–572. DOI: 10.1097/00004583-199806000-00003.
  23. Chokroverty S. An overview of sleep. In: Chokroverty S, ed., Sleep Disorders Medicine: Basic Science, Technical Considerations, and Clinical Aspects, 2nd ed., Boston: Butterworth-Heinemann; 1999. pp. 7–20.
  24. Dabaghzadeh F, Khalili H, Ghaeli P, et al. Potential benefits of cyproheptadine in HIV-positive patients under treatment with antiretroviral drugs including efavirenz. Expert Opin Pharmacother 2012;13(18):2613–2624. DOI: 10.1517/14656566.2012.742887.
  25. Dabaghzadeh F, Ghaeli P, Khalili H, et al. Cyproheptadine for prevention of neuropsychiatric adverse effects of efavirenz: a randomized clinical trial. AIDS Patient Care STDS 2013;27(3):146–154. DOI: 10.1089/apc.2012.0410.
  26. Kenedi CA, Goforth HW. A systematic review of the psychiatric side-effects of efavirenz. AIDS Behav 2011;15(8):1803–1818. DOI: 10.1007/s10461-011-9939-5.
  27. Marinho M, Novais C, Marques J, et al. Efavirenz and neuropsychiatric effects–when the treatment complicates matter further. Eur Psychiatry 2017;41(Suppl):S237. DOI: 10.1016/j.eurpsy.2017.01.2255.
  28. Lee HS, Song DH, Kim JH, et al. Cyproheptadine augmentation of haloperidol in chronic schizophrenic patients: a double-blind placebo-controlled study. Int Clin Psychopharmacol 1995;10(2):67–72. DOI: 10.1097/00004850-199506000-00002.
  29. Akhondzadeh S, Mohammadi MR, Amini-Nooshabadi H, et al. Cyproheptadine in treatment of chronic schizophrenia: a double-blind, placebo-controlled study. J Clin Pharm Ther 1999;24(1):49–52. DOI: 10.1046/j.1365-2710.1999.00197.x.
  30. Chaudhry IB, Soni SD, Hellewell JS, et al. Effects of the 5HT antagonist cyproheptadine on neuropsychological function in chronic schizophrenia. Schizophr Res 2002;53(1–2):17–24. DOI: 10.1016/S0920-9964(01)00165-7.
  31. Mathew NT. Pathophysiology, epidemiology, and impact of migraine. Clin Cornerstone 2001;4(3):1–17. DOI: 10.1016/S1098-3597(01)90035-3.
  32. Siow HC, Pozo-Rosich P, Silberstein SD. Frovatriptan for the treatment of cluster headaches. Cephalalgia 2004;24(12):1045–1048. DOI: 10.1111/j.1468-2982.2004.00734.x.
  33. Villalón CM, Olesen J. The role of CGRP in the pathophysiology of migraine and efficacy of CGRP receptor antagonists as acute antimigraine drugs. Pharmacol Ther 2009;124(3):309–323. DOI: 10.1016/j.pharmthera.2009.09.003.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.