I. Bailey
Aug 12, 1961
Citations
0
Influential Citations
5
Citations
Journal
British Medical Journal
Abstract
Cyproheptadine (" periactin ") is a new antihistamine and antiserotonin drug. Its structure is 1-(1 2-5:6dibenzocycloheptatrienylidene) 4 methylpiperidine hydrochloride monohydrate. In animal experiments it antagonizes the bronchoconstrictor effect of serotonin, the ability of serotonin to increase capillary permeability, and the bronchoconstrictor, vasodepressor, and spasmogenic effects of histamine. It protects against active and passive anaphylaxis. Chronic toxicity studies show no ill effect which would prevent its use in man (Merck Institute for Therapeutic Research, 1958). Histamine is known to be implicated in the pathogenesis of allergic reactions and serotonin is thought to be an important additional factor in some species, but very little is known of the significance of serotonin in allergic reactions in man (Jensen, 1960). We thought that as cyproheptadine is both an antihistamine and an antiserotonin it might be useful in the treatment of allergic disorders. A preliminary trial in patients attending the allergy clinic at the Manchester Royal Infirmary showed that cyproheptadine was strikingly effective in three out of five patients with chronic urticaria when given in dose of between 2 and 6 mg. daily, whereas it was ineffective in five out of seven patients with bronchial asthma and only partially effective in the other two despite doses of up to 30 mg. daily. No ill effect of the drug was encountered, and in view of its apparent success in urticaria we decided to test its effectiveness in a double-blind trial against a dummy lactose tablet.