title: Anorexia nervosa. Treatment efficacy of cyproheptadine and amitriptyline.
abstract: Patients with anorexia nervosa have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients: cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an anti-depressant effect demonstrated by a significant decrease in the Hamilton depression ratings.
mesh_terms: D000293:Adolescent; D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use*; D000856:Anorexia Nervosa / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D001835:Body Weight / Q000187:drug effects; D002986:Clinical Trials as Topic; D003533:Cyproheptadine / Q000494:pharmacology / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy / Q000209:etiology; D004311:Double-Blind Method; D004614:Emaciation / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D006963:Hyperphagia / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D010919:Placebos
chemical_list: D010919:Placebos; D000639:Amitriptyline; D003533:Cyproheptadine