Cyproheptadine

Cyproheptadine, sold under the brand name Periactin among others, is a first-generation antihistamine which is used to treat allergies. In addition, it has a number of off-label uses, such as treatment of serotonin syndrome, insomnia, and use as an appetite stimulant. The drug is taken orally. It is an antihistamine and hence acts as a histamine H1 receptor antagonist. In addition to its antihistamine activity, cyproheptadine has anticholinergic, antiserotonergic, antidopaminergic, and local anesthetic properties. These activities make cyproheptadine useful for various additional uses besides antihistamine indications. As a first-generation antihistamine, cyproheptadine crosses the blood–brain barrier and can produce sedation. The drug can also produce significant central anticholinergic effects at clinically used doses. Cyproheptadine was patented in 1959 and came into medical use in 1961. In 2023, it was the 234th most commonly prescribed medication in the United States, with more than 1 million prescriptions.