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Someone could have Cyproheptadine in their posession if something doesn't seem right.
Link http://www.uptodate.com/contents/serotonin-syndrome
Antidote: Cyproheptadine — If benzodiazepines and supportive care fail to improve agitation and correct vital signs, we suggest antidotal therapy with cyproheptadine [16]. Cyproheptadine is a histamine-1 receptor antagonist with nonspecific 5-HT1A and 5-HT2A antagonistic properties [16]. It also has weak anticholinergic activity.
Cyproheptadine is available in 4 mg tablets or 2 mg/5 mL syrup [8]. When administered as an antidote for serotonin syndrome, an initial dose of 12 mg is recommended, followed by 2 mg every two hours until clinical response is seen. Cyproheptadine is only available in an oral form, but it may be crushed and given through a nasogastric or orogastric tube.
Cyproheptadine may lead to sedation, but this effect is consistent with the goals of management [1]. Furthermore, as a nonspecific serotonin antagonist, cyproheptadine may produce transient hypotension due to the reversal of serotonin-mediated increases in vascular tone. Such hypotension usually responds to intravenous fluids. Cyproheptadine is rated category B for safety in pregnancy by the US Food and Drug administration (FDA) (table 5) [8].
Definitive evidence of cyproheptadine's effectiveness is lacking. A small study used PET scan to assess 5-HT2 blockade in two volunteers after taking cyproheptadine (12 mg and 18 mg per day for six days). At 12 mg/day, there was 85 percent blockade and at 18 mg/day there was over 95 percent blockade of 5-HT2 receptors in the prefrontal cortex [17]. In addition, many reports describe the successful use of cyproheptadine to treat serotonin syndrome [16,18-23]. The majority of these patients received cyproheptadine at an initial dose of 8 mg, while fewer patients responded to as little as 4 mg and some had no response to as much as 16 mg.
Someone could have Cyproheptadine in their posession if something doesn't seem right.
Link http://www.uptodate.com/contents/serotonin-syndrome
Antidote: Cyproheptadine — If benzodiazepines and supportive care fail to improve agitation and correct vital signs, we suggest antidotal therapy with cyproheptadine [16]. Cyproheptadine is a histamine-1 receptor antagonist with nonspecific 5-HT1A and 5-HT2A antagonistic properties [16]. It also has weak anticholinergic activity.
Cyproheptadine is available in 4 mg tablets or 2 mg/5 mL syrup [8]. When administered as an antidote for serotonin syndrome, an initial dose of 12 mg is recommended, followed by 2 mg every two hours until clinical response is seen. Cyproheptadine is only available in an oral form, but it may be crushed and given through a nasogastric or orogastric tube.
Cyproheptadine may lead to sedation, but this effect is consistent with the goals of management [1]. Furthermore, as a nonspecific serotonin antagonist, cyproheptadine may produce transient hypotension due to the reversal of serotonin-mediated increases in vascular tone. Such hypotension usually responds to intravenous fluids. Cyproheptadine is rated category B for safety in pregnancy by the US Food and Drug administration (FDA) (table 5) [8].
Definitive evidence of cyproheptadine's effectiveness is lacking. A small study used PET scan to assess 5-HT2 blockade in two volunteers after taking cyproheptadine (12 mg and 18 mg per day for six days). At 12 mg/day, there was 85 percent blockade and at 18 mg/day there was over 95 percent blockade of 5-HT2 receptors in the prefrontal cortex [17]. In addition, many reports describe the successful use of cyproheptadine to treat serotonin syndrome [16,18-23]. The majority of these patients received cyproheptadine at an initial dose of 8 mg, while fewer patients responded to as little as 4 mg and some had no response to as much as 16 mg.
