title: Cyproheptadine for the Prevention of Postoperative Delirium: A Pilot Study.
abstract: BACKGROUND
  Postoperative delirium is a common neurobehavioral complication after major surgeries. There is no conclusive approach for prevention of delirium in these patients.
  
  
  OBJECTIVE
  In this study, efficacy of cyproheptadine for prevention of postoperative delirium was evaluated.
  
  
  METHODS
  Delirium status of surgical patients was evaluated postoperatively at the time of admission to the intensive care unit (ICU) using the Confusion Assessment Method (CAM-ICU) scale. Patients without delirium were assigned to the cyproheptadine or placebo group based on the simple randomization method. Patients received cyproheptadine or placebo tablet at a dose of 4 mg 3 times per day for 7 days. Patients were monitored daily for incidence of delirium.
  
  
  RESULTS
  Changes in the incidence rates of delirium over time during the study phase (P = 0.04) and between the groups showed statistically significant differences (P = 0.029). However, severity of delirium was not significantly different between the cyproheptadine and placebo groups during the study period.
  
  
  CONCLUSIONS
  It seems that cyproheptadine with its diverse effects can be a potential option for prevention of postoperative delirium. In this pilot study, cyproheptadine significantly decreased the incidence but not severity of postoperative delirium.
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Mohammadi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Motahareh
authors.initials: M
authors.lastname: Ahmadi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran Khalilih@sina.tums.ac.ir.
authors.forename: Hossein
authors.initials: H
authors.lastname: Khalili
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Horiyeh
authors.initials: H
authors.lastname: Cheraghchi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Arbabi
mesh_terms: D000328:Adult; D000368:Aged; D003533:Cyproheptadine / Q000627:therapeutic use*; D003693:Delirium / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D006634:Histamine H1 Antagonists; D003533:Cyproheptadine
keywords: cyproheptadine; delirium; noncardiac surgery; prevention