In a previous randomized controlled trial, CH use led to rapid and early weight gain in children with growth deficiencies, particularly in the first 4 months of treatment [25]. Formal analysis, No, Is the Subject Area "Body weight" applicable to this article? Owing to unobtainable raw data, we were unable to calculate the standard deviation scores for height, weight, and BMI. Note: Other forms of nutrition therapies, e.g. A previous study showed that a low household income could limit access to adequate diets, particularly for older children, and indicated that parents and caregivers might require dietary guidance to ensure sufficient quantity and quality of the foods eaten at home and to foster healthy eating habits among children [40]. BMI was calculated as weight divided by height squared (kg/m2). The number of outpatient clinic visits was higher in the T-group than in the NT-group. The data for patients who either did not receive CH or received CH at a dosage of 0.3 mg/kg/day for >14 days were retrieved, and BW, BH, and medication duration were assessed. Detailed Description: OBJECTIVES: Primary The patient value was then divided by the corresponding chart value, and the product was multiplied by 100. Failure to thrive (FTT) impairs the expected normal physical growth of children. Sir.It is well known that cyproheptadine hydrochloride (an antihistamine with serotonin-antagonistic activity) has an appetite-stimulating effect and promotes weight gain.1, 2 However, its effect in promoting linear growth in association with weight gain often seems to be overlooked although it has been documented.3-5 We therefore wish to report our observations during 29 months of cyproheptadine administration in a small-for-gestational-age female infant to reemphasize the usefulness of this low-cost drug therapy for growth enhancement. College of Public Health, China Medical University, Taichung, Taiwan, Roles Initially, 2 mg PO 2 or 3 times daily with meals. A woman has told how she feared she'd never become a mum but gave birth to a boy at age 45 after taking Viagra to get pregnant.. Carin Rockind, 48, welcomed a "miracle" baby after trying to have a . Please remove one or more studies before adding more. Yes Varied evidence of efficacy in literature. [7]. Third, it was difficult to accurately exclude subjects with feeding disorders or functional gastrointestinal disorders via a retrospective review of medical records only. Yes No, Is the Subject Area "Body mass index" applicable to this article? The inclusion criteria were as follows: (i) boys aged 311 years and girls aged 310 years at the first visit; (ii) a diagnosis satisfying the criteria of codes 783.41, 783.40, and 783.43 of the International Classification of Disease, 9th Revision, Clinical Modification, as well as other FTT-related codes (as ancillary documents); and (iii) BW below the 3rd percentile or body mass index (BMI) below the 5th percentile (as derived from growth charts and matched for age and sex) at the first visit. here. The exact mechanism underlying the effects of low-dose CH on weight gain in children is not entirely understood; hence, future studies on this matter are warranted. To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Additionally, Comer et al. This study aimed to evaluate the effects of cyproheptadine hydrochloride on growth parameters in prepubertal children with FTT. Writing review & editing, Affiliation To determine the effect of cyproheptadine hydrochloride in the prevention of cancer- or treatment-related weight loss (defined as 5% reduction in weight from baseline measurement) in children who are initiating a course of moderately or highly emetic chemotherapy. It works by blocking a. Thus, we normalized heights, weights, and BMIs for age using the sex-matched median values new growth charts for Taiwanese children and adolescents as the reference. Resources, We found that continuous intake of CH (0.3 mg/kg/day) for at least 14 days (mean: 3.24 months) increased the weight gain velocity and BMI in a linear fashion among prepubertal children (age range: 311 years) with mild-to-moderate wasting (6074% of the median weight standard) but without medical conditions. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01132547, The new site is coming soon - go to the modernized. https://doi.org/10.1371/journal.pone.0258731.t003. All Rights Reserved. Children <3 years-old at the first visit were excluded owing to the difficulty in distinguishing organic FTT from nonorganic FTT in this age group according to a recent report [23]. Formal analysis, CMUCHMC, the site of our study, is not only one of the first National Childrens Hospitals recognized by the Ministry of Health and Welfare in Taiwan but also the largest childrens hospital in central Taiwan. Fourth, the children in the T-group visited our hospital and hence may have received more medical attention than did those with fewer visits. Behavioral interventions include the provision of health education about correct nutritional concepts and appropriate feeding skills to children and their caregivers, whereas environmental modifications include the provision of suitable dining environments, atmospheres, and appliances to patients [8]. Terms of Use| Hence, we retrospectively investigated the effects of CH use on weight in prepubertal children with nonorganic FTT who were treated at a hospital in central Taiwan from 2007 to 2017. Treatment for nonorganic FTT focuses on behavioral and environmental modifications to stimulate the appetite of children and consequently increase their oral food intake [7]. Although unresolved, CH most likely promotes weight gain by acting as an appetite stimulant, thereby increasing calorie intake and causing weight gain. RATIONALE: Cyproheptadine hydrochloride may prevent weight loss caused by cancer or cancer treatment. Table 4 presents the modeling results for the effects of selected determinants on health outcomes in patients with FTT who received CH treatment. The first look at the 'middle aged Love Island' set has been released, which has already been nicknamed the 'Viagra House' by locals after single parents searched for love The mean length of the treatment period was 97.22 days (range: 14532 days). Citation: Lin Y-C, Yen H-R, Tsai F-J, Wang C-H, Chien L-C, Chen A-C, et al. Therefore, the strengths of this study included its large sample size and real-world use of CH. School of Chinese Medicine, China Medical University, Taichung, Taiwan, Roles [19], but required 14 months in the study by SantAnna et al. Behavioral and environmental modifications as well as food supplementation are applied as first-line therapy, albeit often in vain [8, 9]. Thus, further molecular studies of additional pathways are warranted. Studies have shown that histaminergic and serotonergic receptor systems modulate feeding behaviors [1214]. Hence, variations in health behaviors among the study participants should be small. Cyproheptadine is an antihistamine and serotonin antagonist with anticholinergic and calcium channel-blocking properties that is used for migraine prevention . Each additional day of CH treatment increased the median %BW value by 0.121 units. Is the Subject Area "Weight gain" applicable to this article? Weight, height, and body mass index were adjusted for age using the median values in the growth charts for Taiwanese boys and girls as the reference. According to a chart review study on CH for stimulant-induced weight loss, the median time to a response is 65 days [26]. All statistical analyses were performed using SAS version 9.4 software (SAS Institute, Cary, NC). Because our study was retrospective, the allocation of treatment modalities was based on previous choices made by patients and their parents in consultation with their physicians. You have reached the maximum number of saved studies (100). Writing original draft, OUTLINE: This is a multicenter study. No statistically significant difference in the median age-adjusted weight value was noted between the T-group and NT-group during the follow up period. Cyproheptadine (Periactin) is used to relieve allergic symptoms. To investigate the effect of cyproheptadine HCl on the change in weight for age scores after 8 weeks of study drug administration in comparison to placebo. The results of Nemati et al. Max: 32 mg/day. PURPOSE: This randomized phase III trial is studying cyproheptadine hydrochloride to see how well it works in preventing weight loss in young patients receiving chemotherapy for cancer. More than 86% of FTT cases in hospitalized children have nonorganic etiologies, and this percentage is likely to be higher in the outpatient setting [3]. Software, Affiliation Females of childbearing age must not be pregnant. [11] showed that CH therapy increased weight within 2 months and that weight gain velocity proportionately declined as the length of the treatment increased. This study aimed to evaluate the effects of cyproheptadine hydrochloride on growth parameters in prepubertal children with FTT. Megace. Last updated on Oct 10, 2022. November 9, 2021 What is cyproheptadine? Funding acquisition, https://doi.org/10.1371/journal.pone.0258731.t002. Children with growth retardation account for 510% of pediatric outpatient visits [1, 2]. Subsequently, 2,914 patients treated with medications other than CH and 394 patients diagnosed with pathological FTT or a congenital or organic disease were excluded. Resources, Affiliations It's recommended that . Therefore, pharmacological stimulation is employed as adjunctive therapy [10, 11]. Women's health is once again the center of a political ping-pong match with evidence-based science on one side and anti-choice advocates on the other. Effects of cyproheptadine on body weight gain in children with nonorganic failure to thrive in Taiwan: A hospital-based retrospective study Failure to thrive (FTT) impairs the expected normal physical growth of children. Un programa que dej de tener gracia cuando se. Most patients (38%) in the T-group had visited the clinic >5 times compared with none in the NT-group (Table 1). We did not have a sufficient number of case subjects for a stratified analysis to determine whether the linear relationship between weight gain velocity and medication duration extended beyond 4 months. No, Is the Subject Area "Children" applicable to this article? The second hypothesis is based on the effects of CH on gastric activity [27, 28]. Nevertheless, we were unable to assess whether the linear relationship between weight gain velocity and medication duration could extend beyond 4 months. The patients were divided into two groups depending on whether they had (T-group) or had not (NT-group) received cyproheptadine hydrochloride (0.3 mg/kg daily) for at least 14 days. Each value for each patient was matched to the median chart value for a child of the same age and sex as the patient. After adjustment, no differences in %BH, %BW, or %BMI were observed between the T-group and NT-groups (Table 2). Customize your JAMA Network experience by selecting one or more topics from the list below. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, This has been shown in animal models and has clinical relevance as the effects of CH on 5-HT2 and H1 receptors [12, 14, 30, 31] are also observed in humans [15, 32, 33]. In this study we investigated the effect of Cyproheptadine hydrochloride on weight gain in underweight children with anorexia at age group 2 to10 years old. Nonetheless, owing to procedural differences among the studies, it is difficult to make comparisons, draw conclusions, and establish clear guidelines for CH administration. Patients are stratified according to enrolling center and steroid use with cancer treatment (yes vs no). (2021) Effects of cyproheptadine on body weight gain in children with nonorganic failure to thrive in Taiwan: A hospital-based retrospective study. The combination of lysine, vitamins, and cyproheptadine is claimed to aid weight gain, though only the last one has been shown to potentially increase appetite as a side effect (1, 2). School of Chinese Medicine, China Medical University, Taichung, Taiwan, It is a first-generation antihistamine with additional anticholinergic, antiserotonergic, and local anesthetic properties. The medical records of prepubertal children who were newly diagnosed with FTT at China Medical University Hospital between 2007 and 2016 were retrospectively examined. Batch CBD Full-Spectrum Gummies. It receives a large number of visits (e.g., 179,832 clinic visits in 2016) and is very representative of the demography in central Taiwan. Vhody smoothies zvisia od toho, o do nich dte. PLoS ONE 16(10): In a couple of weeks, rock overlords Queens Of The Stone Age will return with their new album In Times New Roman; we've already posted the singles "Emotion Sickness" and "Carnavoyeur Napumpujte ho antioxidantmi a vitamnmi! Smoothie. Applies to the following strengths: 4 mg; 2 mg/5 mL Usual Adult Dose for: Allergic Reaction Allergic Rhinitis Pruritus Urticaria Allergic Conjunctivitis Allergic Urticaria Dermatographism Usual Pediatric Dose for: Allergic Reaction Allergic Rhinitis Pruritus Urticaria Allergic Conjunctivitis Allergic Urticaria Archives of Neurology & Psychiatry (1919-1959), JAMA Surgery Guide to Statistics and Methods, Antiretroviral Drugs for HIV Treatment and Prevention in Adults - 2022 IAS-USA Recommendations, CONSERVE 2021 Guidelines for Reporting Trials Modified for the COVID-19 Pandemic, Global Burden of Skin Diseases, 1990-2017, Guidelines for Reporting Outcomes in Trial Protocols: The SPIRIT-Outcomes 2022 Extension, Mass Violence and the Complex Spectrum of Mental Illness and Mental Functioning, Organization and Performance of US Health Systems, Spirituality in Serious Illness and Health, The US Medicaid Program: Coverage, Financing, Reforms, and Implications for Health Equity, Screening for Prediabetes and Type 2 Diabetes, Statins for Primary Prevention of Cardiovascular Disease, Vitamin and Mineral Supplements for Primary Prevention of of Cardiovascular Disease and Cancer, Statement on Potentially Offensive Content, Register for email alerts with links to free full-text articles. To compensate, we incorporated the number of visits into the time variable of our linear model, as shown in Table 4. Am J Dis Child. Writing review & editing, * E-mail: roting@mail.cmu.edu.tw (RTL); d8427@mail.cmuh.org.tw (ACC), Affiliation "Vitamn C njdete v ovoc, ako s pomarane a jahody, a vitamn E v . Department of Pediatrics, China Medical University Childrens Hospital, Taichung, Taiwan, Yes Pediatric Patient Graphics Showing results for cyproheptadine Preventive treatment of migraine in children below. https://doi.org/10.1371/journal.pone.0258731.g001. Materials and Methods: In this . It was because the medication duration in our study varied widely, ranging from 14 days to 532 days, and the number of subjects was insufficient for stratified analysis. Photo: Andreas Neumann. Considerable weight gain occurred within 2 weeks in the study by Rerksuppaphol et al. The median %BW value did not differ significantly between the T-group and NT-group. View Free Coupon Uses Cyproheptadine is an antihistamine used to relieve allergy symptoms such as watery eyes, runny nose, itching eyes /nose, sneezing, hives, and itching. First, it had a retrospective study design that involved a chart review; hence, the causal relationship between CH treatment and weight gain cannot be confirmed. https://doi.org/10.1371/journal.pone.0258731, Editor: Tai-Heng Chen, Kaohsuing Medical University Hospital, TAIWAN, Received: February 22, 2021; Accepted: October 4, 2021; Published: October 19, 2021. Further prospective clinical studies with a. longer and consistent treatment course is warranted. Table 3 presents the modeling results for the effects of selected determinants on health outcomes in all subjects with FTT. The demographic and anthropometric characteristics of the study groups at the first visit are summarized in Table 2. Brief Summary: The purpose of this study is to examine the effect of standard dosing of cyproheptadine for both cycled and continuous administration, as compared to no medication, on appetite stimulation and growth in the pediatric gastroenterology feeding team patient population. Initiation of other appetite enhancing agents, including steroids prescribed for the intent of weight gain, i.e. The infant's birth weight had been 2.32 kg (7 days as part of their cancer treatment regimen are excluded from participation. Nevertheless, the length of the treatment in our study varied widely, ranging from at least 14 days to 532 days. Data were collected from the records of children treated for nonorganic FTT at the pediatric endocrinology and gastroenterology outpatient clinic at China Medical University Hospital Childrens Hospital Medical Center (CMUCHMC) in Taichung, Taiwan, between January 1, 2007 and December 31, 2017. If weight gain or appetite stimulation does not occur within the first few weeks, discontinue. Supervision, For general information, Learn About Clinical Studies. Because severity potentially affects weight gain velocity, we might have underestimated the benefits of CH treatment. They were divided into two groups: those who had received CH treatment (0.3 mg/kg/day, the T-group, N = 50) and those who had not (the NT-group, N = 738) (Fig 1). Additionally, children possess different feeding skills at different ages and exhibit different growth trends before versus during puberty [2022]. Patients or parents complete medicine logs at each follow-up visit in weeks 4 and 8 to evaluate drug compliance and tolerance. This is equivalent to a weight gain of 26.45 g/day, which was calculated by multiplying the daily weight gain unit (0.121) by the average standard weight of the T-group (21.86 kg). Study record managers: refer to the Data Element Definitions if submitting registration or results information. The most common medicine used to increase appetite is cyproheptadine, sold under the brand name Periactin. Data curation, 2023 American Medical Association. Reported side effects such as tachycardia, constipation, diarrhea, irritability, and sleepiness are resolved by decreasing the dosage of CH or discontinuing the treatment [7, 27, 28]. 3-5 We therefore wish to report our observations during 29 months of . Accessibility Statement, Our website uses cookies to enhance your experience. More than half (57.9%) of the patients the NT-group had visited the clinic only twice. Formal analysis, Although we did not consider prior behavioral or environmental interventions in the present study, we note that health education, which includes information on behavioral and environmental modification, is the first-line treatment for children with non-organic FTT at our hospital. broad scope, and wide readership a perfect fit for your research every time. [34] showed that CH increases the number of eating occasions, suggesting that its actions may be more related to postprandial satiety/hunger signaling than to a food reward pathway. Ultimately, 788 eligible patients were included in this study. Resources, Affiliations He armed himself with a balaclava, latex gloves, condoms and Viagra pills and posed as a cab driver in a Mercedes to roam the streets of Brighton, East Sussex. Owing to the lack of information on household income in the present study, we might have underestimated the benefits of CH treatment. It may also be prescribed to your child to increase his or her appetite to help with emptying of the stomach and improve symptoms of nausea and vomiting. FTT is associated with long-term negative health and developmental consequences, including short stature, cognitive disorders, behavioral abnormalities [4], and higher risk of respiratory syncytial virus infection and hospitalization [5]. 510 % of pediatric outpatient visits [ 1, 2 ] patients are stratified according to enrolling and! Possess different feeding skills at different ages and exhibit different growth trends before versus puberty. Feeding behaviors [ 1214 ] no, is the Subject Area `` Pediatrics '' applicable this... ( especially in children ) fourth, the strengths of this study aimed to evaluate the of. As shown in table 4 children in the T-group visited our hospital and hence may have more..., Affiliation Females of childbearing age must not be pregnant taken by mouth visit in weeks 4 8. 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