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Re: cyproheptadine sucks

Posted by Sad Panda on June 4, 2004, at 15:20:52

In reply to Re: cyproheptadine sucks » Questionmark, posted by King Vultan on June 3, 2004, at 8:07:14

> > Okay, i have a prescription for 4mg cyproheptadine (Periactin) tablets to help combat my atrocious anorgasmia from Nardil (60mg/day). The other night i took a full 4mg tablet for only the second time and am now pretty convinced that i hate it. Not only did it not help with the anorgasmia, but during the process of doing what i was using it for, i was so stINKing drowsy that any caresses and what not just kept putting me into little microsleeps! i was so dang tired that i couldn't even concentrate on what i was doing or even stay fully awake! And on top of all THAT, Mr. Softy Jenkins complETEly "fell asleep"!! (And i do not normally suffer from ED so this was especially surprising and frusterating.) All of this also occurred the only other time i took a full 4mg of cyproheptadine (which really isn't even that much either, i believe).
> > And then today-- as with the 1st time-- i have been HORRIbly tired and lethargic all freaking day. It feels remarkably similar to antihistamine "hangovers" from other H1 antagonists. This is not surprising since it also has H1-blocking properties, but i read somewhere that it had a half-life of 4 hours so i didn't think i would have to deal with the next-day fatigue and stupifaction like i do with diphenhydramine and, ugh, Remeron. But no, i have slept almost this entire day. FORTunately i didn't have anything important to do today. Also, fortunately, i didn't really notice any antiserotonergic effects, and i tried to be observant about that (although i wANTed the antiserotonergic property of an ease in ability to orgasm). But the antihistamine effects were enough to make me ticked off and hate the stupid drug.
> > Thus, cyproheptadine, like Remeron, was a bust. And i would advise anyone interested in it who is sensitive to antihistamine effects to either be very judicious or to use another route.
> > Why can't they make a 5-HT2 (is it 5-HT2A or 5-HT2C, or both?) antagonist that's not also a potent antihistamine?!
> > Next up, amantadine. (No more H1 blockers for awhile).
> >
> > Oh, P.S., if anyone has any idea, what do you think the reason would be for the ED that i experienced with cyproheptadine? Is it strongly anticholinergic?
>
>
> Most antihistamines are also anticholinergic, but I do not believe cyproheptadine is as strong, as say, diphenhydramine, as it is not discussed in my book "Psychotropic Drugs" as a treatment for Parkinson's Disease as diphenhydramine is (due to that drug's anticholinergic properties). Cyproheptadine is not even listed in the index, but it does show up in a table of drugs used to treat sexual dysfunction. It is indicated for anorgasmia and hypoactive desire, but your experience is certainly not encouraging.
>
> It's thought that it is stimulation of the serotonin 2A receptors that are responsible for the anorgasmia problems caused by Nardil, the SSRIs, and Effexor. As you are finding out, this can be very difficult to treat. Many of the drugs that block these receptors such as Remeron, trazodone, and nortriptyline also have H1 blockades that cause sedation/hangover problems for some people (myself included). One other one I can think of that might work is nefazodone, which is less sedating than trazodone, but I don't know if you can get away with using this with an MAOI. I've seen warnings, but they may or may not be valid, as I've seen warnings for drugs like the tricyclics also, many of which can be used with MAOIs. Another option is the blasted atypical antipsychotics, which all blockade 5HT-2A receptors. Incidentally, the drugs specifically listed for anorgasmia in the table in my book are amantadine, bupropion, buspirone, cyproheptadine, dextroamphetamine, granisetron, methyphenidate, pemoline, and yohimbine. Of these, my understanding is that buspirone is definitely prohibited with an MAOI, but some of the others may be problematic also.
>
> Todd
>
>

I think it's more likely to be 5-HT2C that is linked to anorgasmia & most psychoactive meds seem to be selective for 5-HT2A.

Cyproheptadine is a H1 & non-selective 5-HT1 & 5-HT2 antagonist that is a used as migraine prophylaxsis mostly in children. Methysergide might be worth a try too, it is a 5-HT1A agonist/non-selective 5-HT2 antagonist that is said to be the best drug for use as migraine prophylaxsis. It is an ergot derivative that has a rather mixed bunch of potential side effects including euphoria & hallucinations which probably shouldn't be too surprising since it is a relative of sorts to LSD.

Cheers,
Panda.



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poster:Sad Panda thread:353270
URL: http://www.dr-bob.org/babble/20040602/msgs/353818.html