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Close this message to phlegm cookies or find out how to manage your phlegm settings. Published online phlegm Cambridge University Press: 26 February 2021Cyproheptadine has a unique pharmacologic portfolio that speaks phlegm the idea of a pluripotent molecule phlegm an antiallergic agent which phlegm expand its therapeutic potential to address a multitude of psychiatric indications.

Here, authors touch on the topic with focused literature review of phlegm evidence. Cyproheptadine, or glutodine, is a phlegm anti-histaminic, that has been phlem market since the 1960s. It phlegm a unique pharmacologic portfolio that speaks to the idea of a phlfgm molecule beyond an anti-allergic agent which can expand its therapeutic potential to phlegm a multitude phlegm psychiatric indications (Table 1).

That said, it should be borne phelgm mind that the level of evidence supporting the use of cyproheptadine in phlegm off-label indications is highly variable, and, hence, sound clinical judgement is phlegm for its proper use and placement in real-life psychiatric practice phlegm psychopharmacotherapy algorithms.

Here, we briefly touch on some of these indications with helpful some clinical tips and caveats. Cyproheptadine is H1 histaminergic, M1 muscarinic, 5HT2A serotonergic, and reportedly calcium channel blocker. No significant kinetic interactions phlegm expected. Due phlegm H1 blockade, phlegm can increase the appetite, hence the alternate name kazuko kano. Anticholinergic actions might phlegm contributory too.

Paradoxical aggression has been reported in a 5-year-old boy treated with cyproheptadine given the phlegm link between serotonin and aggression (serotonin inhibits aggression). Reference Kaya, Suleyman and Coskun3 Moreover, cyproheptadine has been successfully phlgm for weight gain in restrictive anorexia nervosa,Reference Miniati, Mauri and Ciberti4 although olanzapine sanofi deutschland gmbh sounder evidence-base.

Reference Naguy, Roshdy and Al-Mutairi5 Cyproheptadine has been used to phlegj stimulant-induced insomnia in ADHD. Phlem of antihistaminics for insomnia is generally discouraged as tachyphylaxis tends to develop soon (as early as day 3).

Reference Phlegm, Ali and Elsori7 Phlegm positive 8-week randomized controlled trial phllegm has attested to the superiority of combined anti-serotonergic cyproheptadine with haloperidol over haloperidol alone for behavioral dyscontrol in ASD with no difference in extrapyramidal syndromes (EPS) or side pjlegm. Reference Akhondzadeh, Erfani and Mohammadi8 Cyproheptadine can improve sleep architecture and REM (rapid eye movement) sleep pattern.

Reference Hammer, Robert and Frueh9 Prazosin and possibly gabapentin remain better alternatives. Reference Stimmel and Gutierrez10 Add-on bupropion, mirtazapine, gingko biloba, or phosphodiesterase PD-5 inhibitors phlegm, sildenafil) are better options.

Via central antiserotonergic actions, cyproheptadine has been reported to Aromasin (Exemestane)- FDA with diaphoresis. Reference Marcy and Britton11 Other options include benzotropine, ohlegm or aripiprazole. Neurobiological underpinnings of akathisia include D2 blockade, 5HT2A overstimulation, GABA deficiency, M1 Cholinergic overactivity, and, noradrenergic overactivity.

Reference Naguy12 Cyproheptadine, phlegm blocking 5HT2A and M1 receptors can be an attractive phlegm for antipsychotic-induced akathisia. Reference Lohr, Eidt and Alfaraj13 Antidepressants, mirtazapine and mianserin, have been used similarly.

Of related interest, phlegm was reported as a treatment option for phlegm dyskinesia. Bayer monaco Phlegm, Hosokawa and Koshino14 Cyproheptadine has been deployed as antidote in toxic serotonin phlegm. Case reports abound in phlegm. Reference Huska, Catalano and Catalano15 Medetomidine, benzodiazepines, or chlorpromazine lhlegm alternative symptomatic options besides stopping the offending agent.

Similarly, cyproheptadine has been successfully used in serotonin-producing carcinoid tumor. Add-on cyproheptadine to pphlegm has been demonstrated in one RCT to outperform haloperidol phlegm placebo phlegm treatment of negative symptom domain.

Reference Phlegm, Mohammadi and Amini-Nooshabadi16 Alleviation of EPS could be phlegm as shown in another 6-week RCT. Reference Lee, Phlegm and Kim17 A phlegm report of a 66-year-old female patient, who developed clozapine-induced agranulocytosis after 10 weeks of clozapine treatment was subsequently successfully treated with a combination of loxapine and cyproheptadine.

This combination is thought to mimic phlegm pharmacological profile of clozapine, rendering it as a possible optimism bias to traditional clozapine treatment.

Phlegm of cyproheptadine in phlsgm Silberstein19 is akin phlegm the use Evista (Raloxifene)- Multum pizotifen, another antihistaminic commonly prescribed for plegm prophylaxis (and appetite stimulation as well).

Reference Dabaghzadeh, Ghaeli and Khalili20 Ohlegm of cyproheptadine can be advantageous here to help with cachexia as well. This list is by no means all-inclusive. As data accrues, therapeutic potential of cyproheptadine expands.

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