Cyproheptadine side

To anticipate briefly, shortening the length of the side chain in the phenothiazines from three to two carbon atoms changes I he activity of the products from neuroleptics to antihistaminic iigents. A rather similar effect is seen in the tricyclic antidepressants. Reaction of ketone, 27, with the Grignard reagent I rom 4-chloro-l-methylpipyridine (35) affords the tertiary alco-liol, 36. Dehydration gives the antihistamine, cyproheptadine (37). ... 

Cyproheptadine is not an addictive or habit-forming substance. In the study referenced above, it was administered three times per day with a total daily dose from 12 to 32mg/day. Common side effects of this medication include drowsiness, dry mouth, and drying of the nasal passages and airways. Caution should be exercised when administering cyproheptadine with other sedating medications. 

The closest things to true antiserotonin medications used by psychiatrists are those used to treat serotonin-induced side effects. In particular, cyproheptadine has an overall serotonin-blocking effect. With repeated use, this medication can theoretically cause depression and anxiety, and there are case reports of recurrence of depressive symptoms following frequent administration of cyproheptadine. 

There are some prophylactic treatments which are very individualized. Propanolol (p-blocker) has been used at 80-160 mg/day for up to 12 months. Methylsergide and dihydroergotamine(DHE), relatives of ergotamine, are used but have some serious side effects. Antihistamines such as cyproheptadine (Periactin ) have also been found to have tryptaminergic and anticholinergic activity in the CNS and can be used prophylactically. Calcium channel blockers have also been mentioned in an experimental vein. 

NITRATES 1. ANALGESICS-nefopam 2. ANTIARRHYTHMICS -disopyramide, propafenone 3. ANTIDEPRESSANTS-TCAs 4. ANTI EMETICS-cydizine 5. ANTIHISTAMINES -chlorphenamine, cyproheptadine, hydroxyzine 6. ANTIMUSCARINICS -atropine, benzatropine, cydopentolate, dicydover-ine, flavoxate, homat-ropine, hyoscine, orphenadrine, oxybutynin, procyclidine, propantheline, tolterodine, trihexyphenidyl, tropicamide. 7. ANTI-PARKINSON S DRUGS-dopaminergics 8. ANTI-PSYCHOTICS - pheno-thiazines, clozapine, pimozide 9. MUSCLE RELAXANTS-baclofen 1. t risk of antimuscarinic side-effects when isosorbide dinitrate is co-administered with these drugs 2. 1 efficacy of sublingual nitrate tablets... 

Prototypical agent Diphenhydramine. Other first-generation antihistamines include chlorpheniramine, clemastine, promethazine, and cyproheptadine. Second-generation antihistamines— loratadine, cetirizine, and fexofenadine—were developed to circumvent anticholinergic and sedative side effects. 

Sexual dysfunction, delayed or absent ejaculation in men, and anorgasmia in women, are common SSRI side effects. Decreased libido may also be caused by the SSRIs. These side effects often may be diminished by dose reduction, drug holidays, or the use of other medications as antidotes, such as yohimbine, cyproheptadine, or buproprion. 

Cyproheptadine po.sscs.ses both antihistamine and antisc-rotonin activity and is used as an antipruritic agent. Sedation is the most prominent side effect, and this is usually brief, disappearing after 3 or 4 days of tieatmcnt. 

Cyproheptadine can decrease ACTH secretion in the Cushing s disease patient. Morning plasma cortisol concentrations, as well as 24-hour urinary cortisol (free) concentrations should be monitored. Side effects are minor and include sedation and hyperphagia. Cyproheptadine should be reserved for nonsurgical candidates who fail more conventional therapy. Because the response rate is no more than 30%, patients should be followed closely for relapses. 

Commonly prescribed medications to prevent migraines are amitriptyline, divaproex sodium, propranol, timolol, topiramate, bupropion, cyproheptadine, diltiazem, doxepin, fluvoxamine, ibuprofen, imipramine, and methysergide. Methysergide is particularly effective. However, there are side effects that might make this dmg less tolerable. 

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