Tag Archives: Cyproheptadine

Preventive Treatment for Migraine

Migraine is a common episodic headache disorder characterized by attacks that consist of various combinations of headache and neurologie, gastrointestinal, and autonomie symptoms. It has a one-year prevalence of approximately 18% in women, 6% in men, and 4% in children. The second edition of the International Classification of Headache Disorders (ICHD-2) subclassifies migraine into migraine… Read More »

Specific Migraine-Preventive Agents: Serotonin Antagonists

The antiserotonin, migraine-preventive drugs are potent 5-HT2B- and 5-HT2C-receptor antagonists, whereas metachlorophenyl piperazine (mCPP), a 5-HT2B- and 5-HT2C-receptor agonist, induces migraine in susceptible individuals. Methysergide, cyproheptadine, and pizotifen, effective migraine prophylactic drugs, are 5-HT2B-and 5-HT2C-receptor antagonists, whereas ketanserin, a selective 5-HT2A- and a poor 5-HT2B- and 5-HT2C-receptor antagonist, is not. mCPP, a major metabolite of… Read More »

Side Effects of Clomipramine

Anafranil (clomipramine hydrochloride) is available as capsules of 25, 50, and 75 mg for oral administration. The side effects of clomipramine (trademarked as Anafranil and Clofranil) are typical of those seen with other TCAs. The literature disagrees on the relationship between side effects and plasma levels. Stern et al. (1980) found no relationship between side… Read More »

A young woman with migraines, depression, and anxiety complaining of headache, fever, and diarrhea…

A young woman with migraines, depression, and anxiety is seen in the emergency department (ED) complaining of headache, fever, and diarrhea. She is diaphoretic and mildly agitated, with tachycardia but normal blood pressure. Her neurology examination is remarkable only for hyperreflexia without spasticity. Her magnetic resonance imaging (MRI) scan of the brain is normal. What… Read More »

Treatment for Panic Disorder and Agoraphobia

Medical management Effective treatment of panic disorder depends upon establishing and communicating the diagnosis. Initially, many patients are convinced that they are physically ill and resist the idea that their problem may be psychiatric (). Other patients reject the diagnosis of panic disorder because, for them, it implies weakness or responsibility for symptoms. Of course,… Read More »

Fluoxetine 10 mg, 20 mg, 40 mg Capsules

Fluoxetine (floo-ox-uh-teen) [Prozac, Prozac Weekly, Sarafem] Fluoxetine Classification (The therapeutic classification, which categorizes drugs by the disease state they are used to treat, appears first, followed by the pharmacologic classification, which is based on the drug’s mechanism of action.) Therapeutic class: antidepressants Pharmacologic class of Fluoxetine: selective serotonin reuptake inhibitors (selective serotonin reuptake inhibitors (SSRIs)… Read More »

Which of the drugs appears to be the most effective preventative drug for children and adolescents with headaches?

Which of the following appears to be the most effective preventative medication for children and adolescents with migraine headaches? A. Propranolol (Inderal) B. Gabapentin (Neurontin) C. Topiramate (Topamax) D. Levetiracetam (Keppra) E. Zonisamide (Zonegran) The answer is C. Data on preventative medication for children and adolescents with migraine headaches is sparse, as noted by the… Read More »

Which one of the drugs is a proven agent, available in the US, for the preventative treatment of migraine headaches in children?

Which one of the following medications is a proven efficacious agent, available in the United States, for the preventative treatment of migraine headaches in children? A. Propranolol (Inderal) B. Flunarizine C. Cyproheptadine (Periactin) D. Divalproex sodium (Depakote) E. None of the above The answer is E. Flunarizine, a Ca-channel blocker, is probably effective for the… Read More »

Pharmacotherapy for PTSD: Anxiolytics

The anxiolytics initially might seem to be beneficial as a class in posttraumatic stress disorder because the hyperarousal symptoms of posttraumatic stress disorder resemble general anxiety symptoms that are helped by benzodiazepines. Benzodiazepines Three open trials of both alprazolam and clonazepam in posttraumatic stress disorder have been done. The only randomized, double-blind study reported with… Read More »

Long-Term Treatment Issues of Panic Disorder

Among the effective treatments, the response rates range from 50% to 70%. Long-term observations (1.5-6 years after initial treatment) show that 50%-80% of patients have residual panic-related anxiety, 40% have panic attacks, and 20% remain unimproved and seriously ill. Factors that appear to contribute to persistent symptoms include coexisting depression, other anxiety disorders, concomitant personality… Read More »