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Cyproheptadine

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Critical Care Toxicology

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Abstract

Cyproheptadine is a first-generation piperidine antihistamine that is an antagonist at H1 receptors and some serotonin receptor subtypes [1, 2]. Labeled uses of cyproheptadine include those related to its antihistaminic properties, such as allergic rhinitis and urticaria. Off-label, it has been used for its antiserotonergic properties including appetite stimulation in chronic disease, migraine prophylaxis, treatment of pruritus and spasticity associated with spinal cord injury, and management of serotonin syndromes [2–4]. Its use as an adjuvant in the treatment of baclofen withdrawal has also been reported [5–8]. The focus of this chapter is the use of cyproheptadine for the management of serotonin syndrome.

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Author information

Authors and Affiliations

  1. Northern New England Poison Center, MaineHealth/Maine Medical Center, Portland, ME, USA

    Karen E. Simone

Authors
  1. Karen E. Simone
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Correspondence to Karen E. Simone .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Simone, K.E. (2016). Cyproheptadine. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_168-1

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_168-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-20790-2

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