Posted by Sunnely on March 30, 2001, at 23:21:37
In reply to Re: Newbie with question about sexual side effects, posted by Jennie W. on March 30, 2001, at 4:29:00
Hi Jeannie,
Cyproheptadine (Periactin) is an antihistamine and a serotonin receptor antagonist (5HT2). It is one of the agents prescribed to alleviate antidepressant-induced sexual dysfunctions (e.g., decreased libido and lack of orgasm). Sexual disturbances are common side effects of SSRIs. These are supposedly due to their serotonin-enhancing effect which cyproheptadine supposedly counteracts. For SRI-induced (serotonin-reuptake inhibitor) sexual side effects, cyproheptadine is usually prescribed between 2 to 8 mg daily or 4 mg to 12 mg as needed, 1-2 hours before sexual activity. A couple of caveats though: 1) because of its histaminic- and serotonin-blocking effect, it can cause sedation; also increase one's appetite and subsequently, weight gain, and 2) due to its serotonin antagonism, may decrease the antidepressant effect of the SRIs, hence causing relapse of depression. (There have been anecdotal reports of depression and suicidal thoughts with use of cyproheptadine.)
If you are no longer on an SRI (currently on Wellbutrin), I am not clear as to why cyproheptadine was added since Wellbutrin does not have serotonin-enhancing effect and therefore does not induce sexual side effects via this pathway. In fact, because of its dopaminergic effect (mediates pleasure, increases sex drive, and promotes orgasm), Wellbutrin is sometimes considered a pro-sexual drug.
There have been reports that cyproheptadine is effective for treating PTSD (posttraumatic stress disorder)-related nightmares. On the other hand, in one VA study in 1999, cypropheptadine was found generally ineffective for treating nightmares and was often poorly tolerated (fatigue, restlessness, worsening nightmares).
Finally, since cyproheptadine has serotonin antagonism, it is sometimes used as an "antidote" to serotonin syndrome, a potentially serious reaction usually engendered by the combined use of serotonin-enhancing drugs.
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> Hi Dave,
> Well, from what I've read on this board and on the internet, Periactin can be used sort of as an 'antidote' for sexual side effects. I guess it can also be used to decrease nightmares. Go figure, huh? Haven't filled the prescription yet, but I'll let you know if it works.
>
> Jennie
>
> Hi Jeannie:
>
> Why would your doctor prescribe an antihistamine for your condition? That's what Periactin (generic- cyproheptadine hydrochloride) is.
>
> Dave
poster:Sunnely
thread:57998
URL: http://www.dr-bob.org/babble/20010327/msgs/58170.html