A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia.
Anorexia, cachexia, and resultant weight loss are major clinical problems in a substantial proportion of patients with advanced cancer. Effective means of alleviating these problematic symptoms are lacking. Extensive clinical data demonstrate a weight enhancing effect for the serotonin antagonist, cyproheptadine, in several clinical situations. In addition, sound basic research suggests that cyproheptadine may be helpful in patients with cancer anorexia/cachexia. Because of this, the authors performed a randomized, placebo-controlled, double-blinded clinical trial using cyproheptadine, 8 mg orally three times a day in 295 patients with advanced malignant disease. Patients assigned to cyproheptadine had less nausea (P = 0.02), less emesis (P = 0.11), more sedation (P = 0.07), and more dizziness (P = 0.01) than placebo patients. Patients' appetites, measured by serial patient-completed questionnaires, appeared to be mildly enhanced by cyproheptadine. Unfortunately, cyproheptadine did not significantly abate progressive weight loss in these patients with advanced malignant disease; patients assigned to cyproheptadine lost an average of 4.5 pounds per month compared to 4.9 pounds per month for patients assigned to a placebo (P = 0.72).
Kardinal
C G
CG
Alton Ochsner Medical Foundation CCOP, New Orleans, Louisiana.
Loprinzi
C L
CL
Schaid
D J
DJ
Hass
A C
AC
Dose
A M
AM
Athmann
L M
LM
Mailliard
J A
JA
McCormack
G W
GW
Gerstner
J B
JB
Schray
M F
MF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000517:prevention & control*; D001066:Appetite / Q000187:drug effects; D002100:Cachexia / Q000517:prevention & control*; D003533:Cyproheptadine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D001068:Feeding and Eating Disorders / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D015430:Weight Gain / Q000187:drug effects
D010919:Placebos; D003533:Cyproheptadine