Cyproheptadine SSRIs

CYPROHEPTADINE SSRIs Antidepressant effect of SSRIs are possibly antagonized by cyproheptadine Cyproheptadine is an antihistamine with antiserotonergic activity Be aware... 

Drugs that may affect SSRIs Drugs that may affect SSRIs include azole antifungals, barbiturates, carbamazepine, cimetidine, cyproheptadine, lithium, macrolides,... 

Agents such as nefazodone, trazodone, and cyproheptadine, used alone or in conjunction with the SSRIs, may be particularly useful in sleep dysregulation and trauma-related nightmares that frequently occur in pediatric PTSD patients. 

Many patients do consider these problems to be a nuisance rather than a reason to terminate SSRI therapy. Others find these problems intolerable. A wide range of treatments have been tried including dopamine agonists including bupropion, yohimbine, cyproheptadine, and sildenafil. Most of these treatments had only anecdotal and open label studies to support their usefulness. However, sildenafil was found to be superior to placebo in a double-blind study ( 445). 

Serotonin syndrome SSRIs, second generation antidepressants, MAOIs, linezolid, tramadol, meperidine, fentanyl, ondansetron, sumatriptan, MDMA, LSD, St. John s wort, ginseng Hypertension, hyperreflexia, tremor, clonus, hyperthermia, hyperactive bowel sounds, diarrhea, mydriasis, agitation, coma onset within hours Sedation (benzodiazepines), paralysis, intubation and ventilation consider 5-HT2 block with cyproheptadine or chlorpromazine... 

Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, interact with drugs including clarithromycin, warfarin, phenelzine, benzotropine, chlorpromazine, diazepam, and cyproheptadine. Cigarette smokers metabolize SSRIs faster. 

Various treatments have been advocated to ameliorate sexual dysfunction in SSRI-treated patients, including 5-HT2-receptor antagonists (cyproheptadine, mianserin, nefazodone) and 5-HT3-receptor antagonists... 

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. 

Treatment of an overdose of the atypical antidepressants and SSRIs is directed primarily toward decontamination of the gastrointestinal tract with activated charcoal, symptomatic treatment, and general supportive care. Management of the serotonin syndrome involves discontinuation of the serotinergic agent and supportive therapy. Beu-zodiazepines, propranolol, and cyproheptadine, a serotonin antagonist, have been used successfully. ... 

SSRIs Agitation, confusion, hallucination, muscle rigidity, hyperthermia, T HR, T BP, seizures Control hyperthermia and seizures—possible use of cyproheptadine, antipsychotics, and BZs... 

Treatment remove causative agent, reduce SSRIs, give j cyproheptadine... 

Cyproheptadine has been shown to reverse anorgasmia caused by selective serotonin reuptake inhibitors (SSRIs)... 

SSRIs (mostly studied with fluoxetine), amitriptyline (especially for binge eating/purging type), cyproheptadine, lithium, olanzapine... 

Coadministration of the antihistamine cyproheptadine or other 5-HT antagonists with SSRIs might be expected to result in a pharmacodynamic interaction (i.e., reduced effectiveness for the SSRI). Cyproheptadine acts to block postsynaptic 5-HT. Lack of antidepressant efficacy has been reported when cyproheptadine was given concurrently with fluoxetine and paroxetine. 

Cyproheptadine has also been observed to block the activity of serotonin reuptake inhibitors (see SSRIs + Cyproheptadine , p.l216). 

Although the mechanism is not fully understood, it has been suggested that because cyproheptadine is a serotonin antagonist it blocks or opposes the serotonergic effects of these SSRIs. 

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