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February 1986

Anorexia NervosaTreatment Efficacy of Cyproheptadine and Amitriptyline

Author Affiliations

From the Departments of Psychiatry, New York Hospital-Cornell Medical Center, Westchester Division, White Plains (Dr Halmi), and University of Minnesota Hospitals, Minneapolis (Dr Eckert), and the Department of Psychology, New York University, New York (Mr LaDu and Dr Cohen).

Arch Gen Psychiatry. 1986;43(2):177-181. doi:10.1001/archpsyc.1986.01800020087011

• Patients with anorexia nervosa have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients: cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an antidepressant effect demonstrated by a significant decrease in the Hamilton depression ratings.