Cyproheptadine

Cyproheptadine (usually as cyproheptadine hydrochloride, trade name Periactin) is an antihistaminic and antiserotonergic agent. It acts as a 5-HT₂ receptor antagonist and also blocks calcium channels.

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Uses

Cyproheptadine is used in the treatment of allergies (specifically Hay fever) and is also used to stimulate appetite in underweight people (e.g. anorexia nervosa).

Cyproheptadine may also be used to combat SSRI-induced sexual dysfunction, but is used cautiously in this manner because it may reverse the effects of the SSRI.

Cyproheptadine is also used for the treatment of Cushing's Syndrome, the treatment of serotonin reactions secondary to meperidine, and may be used, though rarely, as a prophylactic drug for migraine headaches.

Useful in the treatment of Serotonin Syndrome. Antagonise the action of histamine at H1 receptors, reducing histamine-related vasodilation and increased capillary permeability.

They also have anticholinergic activity, some have alpha-blocking activity and some have antiserotonin activity, eg cyproheptadine.

Useful alternative to benzodiazepine hypnotics in the treatment of insomnia. Cyproheptadine may be superior to benzodiazepines in the treatment of insomnia because cyproheptadine enhances sleep quality and quantity whereas benzodiazepines tend to decrease sleep quality.^[1]

Side effects

While not specifically used as a sedative, cyproheptadine causes sedation, likely due to its anti-histamine effects.

Digestive System: epigastric distress (dysphagia), loss of appetite, nausea, vomiting, (it is noted that these side effects are much more common in people with neuromuscular disorders)

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