From the Guidelines
Cyproheptadine can be used as an appetite stimulant, particularly in patients with poor appetite due to medical conditions or medication side effects, with a typical adult dosage of 2-4 mg taken orally three to four times daily, as supported by recent guidelines 1. The use of cyproheptadine as an appetite stimulant is based on its ability to block histamine H1 receptors and serotonin receptors, which affects the hypothalamus and stimulates appetite.
Key Points to Consider
- The medication should be taken with food to minimize stomach irritation, and treatment duration varies based on individual response, but is often reassessed after 2-4 weeks 1.
- Common side effects include drowsiness, dry mouth, and increased weight gain, and it should be used cautiously in elderly patients and those with glaucoma, urinary retention, or cardiovascular disease.
- The appetite-stimulating effects typically begin within a few days of starting treatment, making it a useful option for patients with cancer-related anorexia, HIV-associated wasting, eating disorders, or medication-induced appetite suppression 1.
Important Considerations
- The evidence for the use of cyproheptadine as an appetite stimulant is moderate-grade, and more research is needed to fully understand its effects and optimal dosage 1.
- Other medications, such as megestrol acetate, may also be used as appetite stimulants, but the choice of medication should be based on individual patient needs and medical history 1.
From the Research
Role of Cyproheptadine in Stimulating Appetite
- Cyproheptadine, an antihistamine, has been used as an appetite stimulant in various conditions, including cystic fibrosis and cancer-related cachexia 2, 3, 4, 5.
- Studies have shown that cyproheptadine can increase weight gain and improve appetite in patients with cystic fibrosis and cancer-related cachexia 2, 3, 4, 5.
- The mechanism of action of cyproheptadine as an appetite stimulant is not fully understood, but it is thought to be related to its ability to block serotonin receptors, which can help increase appetite 3.
- Cyproheptadine has been shown to be effective in stimulating appetite in both children and adults with cystic fibrosis and cancer-related cachexia 2, 3, 4, 5.
- The safety and efficacy of cyproheptadine as an appetite stimulant have been demonstrated in several studies, with minimal side effects reported, including mild sedation and increased appetite 3, 4, 6, 5.
Efficacy of Cyproheptadine in Different Conditions
- In cystic fibrosis, cyproheptadine has been shown to improve weight gain and increase appetite, with significant increases in weight and body mass index (BMI) reported in several studies 2, 4, 5.
- In cancer-related cachexia, cyproheptadine has been shown to promote weight gain and improve appetite, with significant increases in weight and weight-for-age z-scores reported in one study 3.
- In dyspeptic symptoms in children, cyproheptadine has been shown to be safe and effective in treating symptoms such as nausea, early satiety, and vomiting, with a response rate of 55% reported in one study 6.
Side Effects and Safety
- Cyproheptadine has been shown to be generally well-tolerated, with minimal side effects reported, including mild sedation, increased appetite, and weight gain 3, 4, 6, 5.
- One study reported that 30% of patients experienced side effects, including somnolence, irritability, and abdominal pain, but only 2 patients discontinued therapy due to side effects 6.