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B U K Li
Cyclic vomiting syndrome (CVS) in children is characterized by frequent hospitalizations, multiple comorbidities, and poor quality of life. In the absence of robust data, the treatment of CVS remains largely empiric starting with the 2008 NASPGHAN Consensus Statement recommendations of cyproheptadine for children < 5 years of age and amitriptyline for those ≥ 5 years with propranolol serving as the second-line agent. Comprehensive management begins with lifestyle alterations, and extends to medications, supplements, and stress reduction therapies...
August 3, 2018: European Journal of Pediatrics
Yomna A Salem, Mohammed E A Hammouda, Noha M Saleh, Mohamed A Abu El-Enin, Saadia M El-Ashry
A rapid, and highly sensitive analytical method were developed for the simultaneous determination of indacaterol maleate (IND) and glycopyrronium bromide (GLY) in their inhaler capsules. Valid ion-pairing chromatographic (IPC) method was performed for separation of GLY in presence of IND using C18 column and mobile phase consisting of acetonitrile: acidified deionized water (60:40% v/v) containing 0.02% sodium dodecyl sulfate (SDS) adjusted to pH 3.0 using OPA (orthophosphoric acid) isocratically eluted at 2...
June 21, 2018: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
Amber Kapuganti, Traci Turner, Christopher J Thomas
Introduction: This retrospective cohort study evaluated effects of buprenorphine/naloxone dose and concomitant use of selected sedating medications on treatment outcomes in patients with opioid use disorder. Methods: Patients enrolled in the buprenorphine/naloxone clinic at the study institution from 2009 until April 2013 were included. There were no exclusion criteria. Part 1 assessed treatment failure within 6 months and time to treatment failure with buprenorphine doses >8 mg and ≤8 mg...
November 2017: The mental health clinician
Tomoya Hirano, Takashi Fujiwara, Hideaki Niwa, Michitake Hirano, Kasumi Ohira, Yusuke Okazaki, Shin Sato, Takashi Umehara, Yuki Maemoto, Akihiro Ito, Minoru Yoshida, Hiroyuki Kagechika
The histone methyltransferase SET7/9 methylates not only histone but also non-histone proteins as substrates, and therefore, SET7/9 inhibitors are considered candidates for the treatment of diseases. Previously, our group identified cyproheptadine, used clinically as a serotonin receptor antagonist and histamine receptor (H1) antagonist, as a novel scaffold of the SET7/9 inhibitor. In this work, we focused on dibenzosuberene as a substructure of cyproheptadine and synthesized derivatives with various functional groups...
June 7, 2018: ChemMedChem
Terrance McGovern, Justin McNamee, Steven Marcus, Josh Kashani
Cyproheptadine is an H-1 antihistamine with anticholinergic and antiserotonergic effects. Cyproheptadine's most common use has been in the management cold-induced urticaria. It is often used in primary care for its side effect of appetite stimulation. Recently there has been increasing interest in its use in the treatment of drug-induced serotonin syndrome. Cyproheptadine overdose is uncommonly reported in the medical literature. We report the rare case of a pediatric cyproheptadine overdose with a confirmatory cyproheptadine level...
August 2017: Clinical practice and cases in emergency medicine
Kimberly Little, Christine M Lin, Paul M Reynolds
BACKGROUND Serotonin syndrome is a condition characterized predominantly by neuromuscular symptoms and altered thermoregulation in response to serotonergic overtone. Treatment is focused on withdrawal of serotonergic agents, which leads to resolution in the majority of cases. In the setting of serotonergic overdose, the onset of serotonin syndrome is usually within 4 to 13 h. Here, we report a case of delayed-onset serotonin syndrome in a patient who ingested a mixture of longer-acting serotonin agonists with serotonin antagonists...
May 25, 2018: American Journal of Case Reports
Sameer Hassamal, Karen Miotto, William Dale, Itai Danovitch
Tramadol is commonly prescribed for pain control because it presents a lower risk for addiction and respiratory depression compared to other opioids. However, tramadol's serotonin and norepinephrine reuptake inhibitory effects result in a unique adverse effect profile. Two such adverse events are serotonin syndrome and seizures. The prevalence of tramadol-induced serotonin syndrome and seizures is modest in the general population, but if left untreated, the morbidity and mortality can be high; therefore, prompt recognition and management is essential...
May 10, 2018: American Journal of Medicine
Shuo Gu, Wing-Yu Fu, Amy K Y Fu, Estella Pui Sze Tong, Fanny C F Ip, Xuhui Huang, Nancy Y Ip
The receptor tyrosine kinase, erythropoietin-producing hepatocellular A4 (EphA4), was recently identified as a molecular target for Alzheimer's disease (AD). We found that blockade of the interaction of the receptor and its ligands, ephrins, alleviates the disease phenotype in an AD transgenic mouse model, suggesting that targeting EphA4 is a potential approach for developing AD interventions. In this study, we identified five FDA-approved drugs-ergoloid, cyproheptadine, nilotinib, abiraterone, and retapamulin-as potential inhibitors of EphA4 by using an integrated approach combining virtual screening with biochemical and cellular assays...
May 9, 2018: Scientific Reports
Christie Sun, Hannah Sweet, Alicia B Minns, Desiree Shapiro, Willough Jenkins
BACKGROUND: Neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS) are serious medical conditions associated with commonly prescribed psychiatric medications. Although the mechanisms differ, they can be clinically difficult to distinguish. We report a case of a pediatric patient with complicated psychiatric history that developed features of both syndromes in the setting of polypharmacy. CASE: A 12-year-old boy with a history of developmental delay, attention-deficit hyperactivity disorder, and posttraumatic stress disorder presented to the emergency department with behavior changes consisting of delayed reactions, gait instability, drooling, and slowed movements...
April 24, 2018: Pediatric Emergency Care
Yan-Lin He, Kai Wang, Qian-Ru Zhao, Yan-Ai Mei
Cyproheptadine (CPH), a first-generation antihistamine, enhances the delayed rectifier outward K+ current (IK ) in mouse cortical neurons through a sigma-1 receptor-mediated protein kinase A pathway. In this study, we aimed to determine the effects of CPH on neuronal excitability in current-clamped pyramidal neurons in mouse medial prefrontal cortex slices. CPH (10 µmol/L) significantly reduced the current density required to generate action potentials (APs) and increased the instantaneous frequency evoked by a depolarizing current...
April 18, 2018: Neuroscience Bulletin
Anne Donnet, Sylvain Redon
PURPOSE OF REVIEW: Cyclic vomiting syndrome (CVS) is a misrecognized and probably underdiagnosed episodic syndrome associated with migraine, occurring preferentially in childhood. Attacks are stereotyped for each individual, with predictable periodicity. This review summarizes recent clinical and paraclinical observations in this syndrome, and current approaches in explorations and therapeutics. RECENT FINDINGS: Clinical phenotype during prodromal, vomiting, and recovery phases contains visceral and neuropsychological symptoms, but also cranial and systemic symptoms...
March 19, 2018: Current Pain and Headache Reports
Maryam Razzaghy-Azar, Mitra Nourbakhsh, Mona Nourbakhsh
BACKGROUND: Cyproheptadine HCl (CyproH) is an appetite-stimulating drug and while it was prescribed for a patient with growth hormone insensitivity syndrome (GHIS) for increasing appetite, his height growth was surprisingly increased. Therefore, the aim of this study was to investigate the effect of CyproH on growth parameters of the patients with GHIS. PATIENTS AND DESIGN: Twenty patients were enrolled in two prospective cohorts at two different times. Fifteen cases were observed for 1...
June 2018: Clinical Endocrinology
Alex Morris, Michael Green, Hayley Martin, Katie Crossland, William T Swaney, Sally M Williamson, Robbie Rae
The ability of parasites to manipulate the behaviour of their hosts has evolved multiple times, and has a clear fitness benefit to the parasite in terms of facilitating growth, reproduction and transfer to suitable hosts. The mechanisms by which these behavioural changes are induced are poorly understood, but in many cases parasite manipulation of serotonergic signalling in the host brain is implicated. Here we report that Phasmarhabditis hermaphrodita, a parasite of terrestrial gastropod molluscs, can alter the behaviour of slugs...
June 2018: Behavioural Processes
Youngjae Ryu, Toru Ogata, Motoshi Nagao, Yasuhiro Sawada, Ryohei Nishimura, Naoki Fujita
Spasticity usually emerges during the course of recovery from spinal cord injury (SCI). While medications and physical rehabilitation are prescribed to alleviate spastic symptoms, the insufficiency of their effects remains an important problem to be addressed. Given the challenges associated with increasing the dose of medication, we hypothesized that a combination therapy with medication and physical rehabilitation can be effective. Therefore, we examined the effects of treadmill training (TMT) along with serotonergic medication using a spastic rat model after contusive injury...
June 15, 2018: Journal of Neurotrauma
Toshiya Inada
Akathisia consists of subjective inner restlessness, such as awareness of the inability to remain seated, restless legs, fidgetiness, and the desire to move constantly, and of objective increased motor phenomena, such as body rocking, shifting from foot to foot, stamping in place, crossing and uncrossing legs, pacing around. Although the broad definition of akathisia includes the inner and motor restlessness observed in patients with idiopathic Parkinson's disease, post-encephalitic parkinsonism, and restless legs syndrome, here we exclusively focus on the narrow definition of antipsychotic-induced akathisia...
December 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
Hafiz Muhammad Abdur Rahman, Samra Bashir, Safur Rehman Mandukhail, Sohaib Huda, Anwarul Hassan Gilani
Achyranthes aspera L. is traditionally used to relieve constipation, diarrhea, and asthma. Its crude extract (Aa.Cr) was evaluated through in vivo and ex vivo experiments to rationalize these medicinal uses of A. aspera and to provide their scientific basis. Aa.Cr, at 3 and 10 mg/kg, increased fecal output, similar to castor oil, whereas at 30, 100, 300, and 700 mg/kg, it protected against castor oil-induced diarrhea in mice when administered orally. Aa.Cr caused spasmogenic effect on rabbit jejunum and guinea pig ileum preparations, which was partially inhibited by atropine while completely blocked by cyproheptadine preincubation...
November 2017: Phytotherapy Research: PTR
Anaïs Lemoine, Madeleine D Harbison, Jennifer Salem, Patrick Tounian, Irène Netchine, Béatrice Dubern
OBJECTIVES: Nutritional management of children with Silver-Russell syndrome (SRS) is crucial, especially before initiating growth hormone therapy. Since cyproheptadine (CYP) has been reported to be orexigenic, we retrospectively investigated the effects of CYP on changes in weight and height in patients with SRS. METHODS: Anthropometric parameters (weight [W], length or height [H], weight on expected weight for height [W/H], and body mass index) were recorded for 34 children with SRS receiving CYP...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
P K Kar, Kvr Chari
In a prospective study a comparison has been made between the clinical efficacy and safety of cetirizine, a third generation H1 receptor antagonist with chlorpheniramine and cyprohepatadine, the most widely used antithistamines in the treatment of chronic idiopathic urticaria. One hundred and five patients with chronic idiopathic urticaria were studied where the effects of chlorpheniramine, 4 mg and cyproheptadine, 4 mg administered twice daily were compared with cetirizine, 10 mg given once daily for 4 weeks or earlier till the relief of symptoms and regression of lesions...
January 1998: Medical Journal, Armed Forces India
Negin Badihian, Hossein Saneian, Shervin Badihian, Omid Yaghini
OBJECTIVES: Cyclic vomiting syndrome (CVS) is a common functional gastrointestinal disorder characterized by recurrent episodes of nausea and vomiting. There is no definite treatment for the condition, although some medications are recommended. We aimed to compare the efficacy of amitriptyline and cyproheptadine in prophylactic therapy of CVS. METHODS: This is a single-blinded randomized clinical trial conducted during 2015-2016 in Isfahan, Iran. Sixty-four children who were 3-15 years old, with a diagnosis of CVS (based on Rome III criteria), were included in the study and were randomly divided into two groups of amitriptyline and cyproheptadine...
January 2018: American Journal of Gastroenterology
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