Cyproheptadine in levodopa‐induced dyskinesia in parkinsonism

Abstract

The neuroendocrine properties and the beneficial effects of cyproheptadine in tardive dyskinesia led to the testing of this drug in levodopa-induced dyskinesia. Cyproheptadine administered to 6 parkinsonian patients in doses of up to 42 mg/day was of no significant benefit in either dyskinesia or symptom control. Improvement in appetite was reported by 3 patients. These observations suggested that different mechanisms may be responsible in the pathogenesis of phenothiazine and amine-induced dyskinesia. The failure to control levodopa-induced dyskinesia selectively with serotonin agonists and antagonists and the accentuation of the dyskinesia in the presence of anticholinergic agents further suggest that substances that increase directly central cholinergic activity may be effective in the control of levodopa-induced dyskinesia.

A Consideration for the Study of the Use of Cyproheptadine in Parkinson Disease Psychosis

“…Cyproheptadine has been studied in the treatment of Parkinson disease in a small study of 6 patients, but this was to explore its effects on levodopa-induced dyskinesia and no significant benefit was found in this study 4 . However, neither rates of adverse effects nor its effect on any Parkinson's-associated psychosis were reported in this study.…”