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A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia.

Author(s): Kardinal CG, Loprinzi CL, Schaid DJ, Hass AC, Dose AM, Athmann LM, Mailliard JA, McCormack GW, Gerstner JB, Schray MF

Affiliation(s): Alton Ochsner Medical Foundation CCOP, New Orleans, Louisiana.

Publication date & source: 1990-06-15, Cancer., 65(12):2657-62.

Publication type: Clinical Trial; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.

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).

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