Posted by ed_uk on June 29, 2005, at 10:32:50
OK, this is an interesting drug. Cyproheptadine is a potent sedating antihistamine which blocks 5-HT2 (2a and 2c) receptors. It's also said to act as a calcium channel blocker. Cyproheptadine has an anticholinergic effect.
So.......what could we use it for????
***Insomnia - could be a useful alternative to other sedating antihistamines. Like Seroquel and Remeron, it blocks 5-HT2 receptors - may enhance the quality of sleep. It's half life is said to be 6-9 hours.
***Antipsychotic induced akathisia - can be a useful treatment.......especially if it's not possible to reduce the dose or switch to a different drug.
***Could it be a useful treatment for anxiety? Perhaps......other 5-HT2 antagonists have been claimed to be anxiolytic.
***Might it be a useful treatment for depression? I do think it might be a useful adjunct to ADs in a few patients. I've read that 5-HT2 antagonism can sometimes add to the AD effect of conventional ADs.
On the other hand, there are case reports of cyproheptadine induced relapses in patients who have been successfully treated with ADs.
Cyproheptadine-induced depressive relapse.........
This is not the only case report! There are several others but they don't have abstracts.
***Cyproheptadine is sometimes an effective treatment for SSRI-induced anorgasmia.
There are numerous case reports - see PubMed.
***Schizophrenia - might improve cognition?
***Schizophrenia - might be a useful adjunct - does it improve negative symptoms?
Might not reduce symptoms - but can it treat EPS?
***Might cyproheptadine be a useful treatment for SSRI-induced apathy? Zyprexa, atypical AP, is claimed to be a useful treatment for SSRI apathy. One of the (many) pharmacological properties of Zyprexa is 5-HT2 antagonism. This property is shared by cyproheptadine. Stimulation of 5-HT2 receptors has been implicated in causing apathy - I don't know how much evidence there is to support this statement though.
***Which SSRI side effect might be relieved by cyproheptadine, a 5-HT2a/5-HT2c antagonist???
'Indeed, SSRIs act mainly by increasing the serotonin level in the synapse, thus leading to a non specific activation of all pre- and post-synaptic serotonin receptors. Among them, 5-HT2A/2C receptors have been involved in some of the unwanted effects of SSRI: agitation, anxiety, insomnia, sexual disorders, etc. The inhibition of these receptors could be thus beneficial for patients treated with SSRI.'
***Can cyproheptadine treat nightmares in PTSD??
***Might cyproheptadine reduce aggression?
http://www.dr-bob.org/tips/split/Cyproheptadine-for-aggress.html
***Might cyproheptadine reduce the serotonergic side effects of MAOI? .......myoclonus is an example.
http://www.dr-bob.org/tips/split/Cyproheptadine-for-myoclon.html
***What is the effect of cyproheptadine on cortisol - a stress hormone?
***Might cyproheptadine treat SSRI-induced sweating?
***Cyproheptadine has been used as a treatment for the serotonin syndrome.
***What else does cyproheptadine do???
1. It increases appetite and causes weight gain
2. It treats mild allergies - it's an antihistamine.
3. It reduces itching in people with skin disorders such as eczema and urticaria.
4. It's claimed to be an effective treatment for migraine - not much evidence AFAIK.
5. It's been used to treat the symptoms of carcinoid syndrome eg. diarrhea.
6. It's been used to treat benign essential blepharospasm.***Cyproheptadine and masturbating cats! See....
....................................................................................................................................
So what's GOOD about cyproheptadine?
1. It's CHEAP :-)
2. It's available without a prescription in some countries.
3. It has multiple uses.
4. RE sleep, it's probably safer than using an AP.
5. It's a very old drug - there's extensive experience with its use.
.......and what's BAD about cyproheptadine?
1. It's not been studied *in detail* for any psychiatric indication.
2. It's often very sedating. If you're anything like me it will probably knock you out. Sedating antihistamines always knock me out!
3. Regualar use of cypro is likely to make you quite fat! Prepare to padlock the fridge - you might start craving food.
4. As is the case with other antihistamines, unpleasant psychiatric side effects have occasionally been reported.
~Ed
PS. I think Linkadge took cypro. Tell us more Link? I think you said it helped you sleep while you were on an SSRI but then you started to feel more depressed.
poster:ed_uk
thread:521042
URL: http://www.dr-bob.org/babble/20050627/msgs/521042.html