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

Carl G. Kardinal, Charles L. Loprinzi, Daniel J. Schaid, A. Curtis Hass, Ann M. Dose, Laureen M. Athmann, James A. Mailliard, Greg W. McCormack, James B. Gerstner, Mark F. Schray

Research output: Contribution to journalArticle

179 Scopus citations

Abstract

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).

Original languageEnglish (US)
Pages (from-to)2657-2662
Number of pages6
JournalCancer
Volume65
Issue number12
DOIs
StatePublished - Jun 15 1990

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Kardinal, C. G., Loprinzi, C. L., Schaid, D. J., Curtis Hass, A., Dose, A. M., Athmann, L. M., Mailliard, J. A., McCormack, G. W., Gerstner, J. B., & Schray, M. F. (1990). A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia. Cancer, 65(12), 2657-2662. https://doi.org/10.1002/1097-0142(19900615)65:12<2657::AID-CNCR2820651210>3.0.CO;2-S