Preventive effect of cyproheptadine on sleep and appetite disorders induced by methylphenidate: an exploratory randomised, double-blinded, placebo-controlled clinical trial

Int J Psychiatry Clin Pract. 2019 Mar;23(1):72-79. doi: 10.1080/13651501.2018.1509095. Epub 2018 Sep 27.

Abstract

Objectives: Insomnia and loss of appetite are the most common side effects of methylphenidate in patients with attention deficit/hyperactivity disorder (ADHD). The adverse effects may limit optimal dosing and patients' compliance with treatment leading to the discontinuation of treatment. This research evaluates the preventive effects of cyproheptadine on sleeping and appetite disorders induced by methylphenidate in ADHD children.

Methods: During this exploratory, randomised, double-blinded, placebo-controlled clinical trial, forty patients with ADHD diagnosis who had received methylphenidate randomly were assigned to participate in the cyproheptadine or the placebo group. Patients' weight and Pittsburgh Sleep Quality Index (PSQI) score were recorded at baseline, after four, six and eight weeks of treatment. The ADHD Parent Rating Scale-V score was also defined at the beginning and the end of study for each patient.

Results: There was no significant difference between the cyproheptadine and the placebo groups regarding their weight, rate of growth and PSQI score in the monthly assessment. In addition, there was no significant difference in response to the therapy between the two groups.

Conclusions: Based on our findings, cyproheptadine does not have any considerable preventive effect on sleeping and appetite disorders induced by methylphenidate in ADHD children.

Keywords: Attention deficit/hyperactivity disorder; cyproheptadine; insomnia; loss of appetite; methylphenidate.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / adverse effects*
  • Child
  • Child, Preschool
  • Cyproheptadine / administration & dosage
  • Cyproheptadine / pharmacology*
  • Double-Blind Method
  • Feeding and Eating Disorders / chemically induced
  • Feeding and Eating Disorders / prevention & control*
  • Female
  • Humans
  • Male
  • Methylphenidate / adverse effects*
  • Pilot Projects
  • Serotonin Antagonists / administration & dosage
  • Serotonin Antagonists / pharmacology*
  • Sleep Wake Disorders / chemically induced
  • Sleep Wake Disorders / prevention & control*
  • Treatment Failure

Substances

  • Central Nervous System Stimulants
  • Serotonin Antagonists
  • Methylphenidate
  • Cyproheptadine