Cyproheptadine

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Cyproheptadine
File:Cyproheptadine.svg
Systematic (IUPAC) name
4-(5H-dibenzo [a,d]cyclohepten-5-ylidene)-1-methylpiperidine hydrochloride
Clinical data
Pregnancy
category
  • US: B (No risk in non-human studies)
Routes of
administration		 Oral only
Legal status
Legal status
Pharmacokinetic data
Protein binding 96 to 99%
Metabolism Hepatic and renal
Biological half-life 1 to 4 hours
Excretion Fecal and renal
Identifiers
CAS Number 129-03-3
ATC code R06AX02 (WHO)
PubChem CID 2913
IUPHAR/BPS 277
DrugBank APRD00033
ChemSpider 2810
Chemical data
Formula C21H21N
Molar mass 287.398 g/mol[[Script error: No such module "String".]]
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Cyproheptadine (brand name Periactin) pronounced /ˌsaɪprɵˈhɛptədiːn/; usually as cyproheptadine hydrochloride is an antihistaminic/anticholinergic and antiserotonergic agent. It also acts as a 5-HT2 receptor antagonist as well as blocking calcium channels.[1]

Uses

Cyproheptadine is used to treat allergic reactions (specifically hay fever).[2]

Cyproheptadine has shown effectiveness in the treatment of nightmares including nightmares related to post traumatic stress disorder.[3][4]

Cyproheptadine has been used in the management of moderate to severe cases of serotonin syndrome (a complex of symptoms associated with the use of serotonergic drugs, such as selective serotonin reuptake inhibitors and monoamine oxidase inhibitors),[5][6][7] and in the disease carcinoid in which serotonin is overproduced by tumor cells.[8][9]

Cyproheptadine can also be used as a preventive measure against migraine in children and adolescents.[10][11][12][13][14]

Cyproheptadine can relieve SSRI-induced sexual dysfunction[15][16] and drug-induced hyperhydrosis (excessive sweating).[17]

Cyproheptadine is used in the prevention of cyclical vomiting syndrome[citation needed] and to stimulate the appetite.[citation needed]

Adverse effects

While not specifically used as a sedative, cyproheptadine causes drowsiness,[18] as is common with first-generation antihistamines.

Research has shown a suppression of growth hormone with doses of 8–12 mg per day taken for 5 days.[19]

Other common side effects include:[20]

  • Dizziness
  • Blurred vision
  • Constipation
  • Dry mouth, throat, or nose
  • Excitability
  • Nausea
  • Nervousness
  • Restlessness

Research

Cyproheptadine has been shown to improve quality of sleep in sleep-deprived rats.[21]

Cyproheptadine interacts with several other medications such as MAOIs (monoamine oxidase inhibitors) and potassium salts and can cause adverse reactions. Anti-cholinergic medications such as Cyproheptadine, when used in conjunction with oral potassium salts, can cause slowing of GI transit and increases the local exposure to high potassium concentrations. High potassium concentrations may lead to GI tract ulceration or stenosis.

Veterinary use

File:Periactin 4 mg.jpg
Periactin 4 mg tablets (AU)

Cyproheptadine is used in cats as an appetite stimulant and as an adjunct in the treatment of asthma.[22][23] Possible adverse effects include excitement and aggressive behavior.[22]

The elimination half-life of cyproheptadine in cats is 12 hours.[23]

References

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Classes
Antidepressants
7-OH-Amoxapine • Amezepine • Amineptine • Amitriptyline • Amitriptylinoxide • Amoxapine • Aptazapine • Azepindole • Azipramine • Butriptyline • Cianopramine • Ciclazindol • Ciclopramine • Clomipramine • Cotriptyline • Cyanodothiepin • Demexiptiline • Depramine/Balipramine • Desipramine • Dibenzepine • Dimetacrine • Dosulepin/Dothiepin • Doxepin • Enprazepine • Esmirtazapine • Fluotracen • Hepzidine • Homopipramol • Imipramine • Imipraminoxide • Intriptyline • Iprindole • Ketipramine • Litracen • Lofepramine • Losindole • Loxapine • Maprotiline • Mariptiline • Mazindol • Melitracen • Metapramine • Mezepine • Mianserin • Mirtazapine • Naranol • Nitroxazepine • Nortriptyline • Noxiptiline • Octriptyline • Opipramol • Oxaprotiline • Pipofezine • Pirandamine • Propizepine • Protriptyline • Quinupramine • Setiptiline/Teciptiline • Tandamine • Tampramine • Tianeptine • Tienopramine • Trimipramine
Antihistamines
Antipsychotics
Acetophenazine • Amoxapine • Asenapine • Butaclamol • Butaperazine • Carphenazine • Carpipramine • Chlorpromazine • Chlorprothixene • Ciclindole • Clocapramine • Clomacran • Clotiapine • Clozapine • Flucindole • Fluotracen • Flupentixol • Fluphenazine • Gevotroline • Homopipramol • Levomepromazine/Methotrimeprazine • Loxapine • Maroxepin • Mesoridazine • Metitepine/Methiothepin • Metoxepin • Mosapramine • Naranol • Olanzapine • Perazine • Perphenazine • Periciazine • Piperacetazine • Pipotiazine • Piquindone • Prochlorperazine • Promazine • Prothipendyl • Quetiapine • Sulforidazine • Thiethylperazine • Thiopropazate • Thioridazine • Thiothixene • Trifluoperazine • Triflupromazine • Zotepine • Zuclopenthixol
Others
de:Cyproheptadin

fa:سیپروهپتادین it:Ciproeptadina ja:シプロヘプタジン pl:Cyproheptadyna pt:Cipro-heptadina

th:ไซโปรเฮปตาดีน
  1. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  2. ↑ MedlinePlus Drug Information: Cyproheptadine
  3. ↑ Rijnders, R. J.P.; Laman, DM; Van Diujn, H (2000). "Cyproheptadine for Posttraumatic Nightmares". American Journal of Psychiatry. 157 (9): 1524–a. doi:10.1176/appi.ajp.157.9.1524-a. PMID 10964879. 
  4. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  5. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  6. ↑ Gillman PK (1999). "The serotonin syndrome and its treatment". Journal of Psychopharmacology (Oxford, England). 13 (1): 100–9. PMID 10221364. 
  7. ↑ Hall M, Buckley N (2003). "Serotonin syndrome". Australian Prescriber. 26 (3): 62–3. 
  8. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  9. ↑ Moertel, Charles G.; Kvols, LK; Rubin, J (1991). "A study of cyproheptadine in the treatment of metastatic carcinoid tumor and the malignant carcinoid syndrome". Cancer. 67 (1): 33. doi:10.1002/1097-0142(19910101)67:1<33::AID-CNCR2820670107>3.0.CO;2-E. PMID 1985720. 
  10. ↑ Wendy G Mitchell; et al. (2006). "Childhood Migraine Variants". 
  11. ↑ UVA Neurogram: Treatment of Pediatric Migraine
  12. ↑ Netdoctor: Periactin
  13. ↑ Migraines in Children and Adolescents
  14. ↑ Klimek A (1979). "Cyproheptadine (Peritol) in the treatment of migraine and related headache". Ther Hung. 27 (2): 93–4. PMID 494146. 
  15. ↑ Keller Ashton A, Hamer R, Rosen RC (1997). "Serotonin reuptake inhibitor-induced sexual dysfunction and its treatment: a large-scale retrospective study of 596 psychiatric outpatients". Journal of Sex & Marital Therapy. 23 (3): 165–75. PMID 9292832. 
  16. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  17. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  18. ↑ Lexi-Comp (August 2008). "Cyproheptadine". The Merck Manual Professional.  Retrieved on October 26, 2008.
  19. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  20. ↑ Cyproheptadine - Drugs.com
  21. ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
  22. ↑ 22.0 22.1 Dowling PM (February 8, 2005). "Drugs Affecting Appetite". In Kahn CM, Line S, Aiello SE (eds.). The Merck Veterinary Manual (9th ed.). John Wiley & Sons. ISBN 0-911910-50-6.  Retrieved on October 26, 2008.
  23. ↑ 23.0 23.1 Dowling PM (February 8, 2005). "Systemic Therapy of Airway Disease: Cyproheptadine". In Kahn CM, Line S, Aiello SE (eds.). The Merck Veterinary Manual (9th ed.). John Wiley & Sons. ISBN 0-911910-50-6.  Retrieved on October 26, 2008.
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