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

Cancer. 1990 Jun 15;65(12):2657-62. doi: 10.1002/1097-0142(19900615)65:12<2657::aid-cncr2820651210>3.0.co;2-s.


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).

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anorexia / prevention & control*
  • Appetite / drug effects
  • Cachexia / prevention & control*
  • Cyproheptadine / adverse effects
  • Cyproheptadine / therapeutic use*
  • Double-Blind Method
  • Feeding and Eating Disorders / prevention & control*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Neoplasms / radiotherapy
  • Placebos
  • Randomized Controlled Trials as Topic
  • Weight Gain / drug effects


  • Placebos
  • Cyproheptadine