Cyproheptadine Use in Children With Functional Gastrointestinal Disorders

Abstract

Cyproheptadine effectively improves symptoms of Rome III-defined FGIDs and has a good safety profile when used for these indications.

Cyproheptadine: A Potentially Effective Treatment for Functional Gastrointestinal Disorders in Children

“…Worawattanakul et al 12 studied the role of cyproheptadine in abdominal migraine prophylaxis in 12 patients, and 10 of these patients had fair to excellent response. Madani et al 10 demonstrated complete resolution of symptoms in 13 of 18 patients with AM treated with cyproheptadine (72% response rate). Lewis 55 noted that cyproheptadine is a simple, effective, and safe treatment option for AM in children younger than age 10 years who are not overweight.…”

“…47 Cyproheptadine, a nonselective antagonist of 5-HT2A and 5-HT2B, has not been formally studied in FD in humans. 18 To date, there are only two published retrospective studies (Madani et al 10 and Rodriguez et al 11 ) that showed efficacy of cyproheptadine in a majority of children diagnosed with Rome IIIdefined FD (77% and 55% resolution of symptoms, respectively).…”

“…Efficacy of cyproheptadine was also demonstrated in a retrospective study in 2016 among 55 patients who met Rome III criteria for FAP, with 66% experiencing complete resolution of abdominal pain. 10 …”

“…Although cyproheptadine has been shown to be effective in prevention of migraine headache in children, 54 there are data suggesting its beneficial effects in AM 10,12,13 (Table 1). Pfau et al 13 reported complete abatement of symptoms in 3 of 4 patients with AM treated with cyproheptadine.…”

“…8 Its efficacy in children with FAP has been reported in a double-blind, placebo-controlled trial, 9 as well as in retrospective studies for treatment of FAP, FD, IBS, and AM. [10][11][12][13][14][15][16] 5-HT is a polyfunctional signaling molecule that serves as a paracrine factor, endocrine hormone, neurotransmitter, and growth factor. 17 Various 5-HT receptor subtypes regulate gut motility, secretion, and visceral sensitivity.…”