Action of cyproheptadine in spastic paraparetic patients.

Abstract

The antiserotonergic agent cyproheptadine was evaluated in 6 patients as a medication for the management of spasticity due either to spinal cord trauma or to multiple sclerosis. Oral doses of cyproheptadine were progressively increased from 6 mg to 24 mg per day. Trial periods extended from 4 to 24 mo. and included a placebo substitution period. Cyproheptadine decreased significantly the spontaneous and elicited ankle clonus in all 6 patients and spontaneous spasms in 5 patients. Cyproheptadine decreased the EMG [electromyograph] activity and the dynamic strength produced by the knee extensor and flexor muscles during isokinetic movements in 2 of the 4 patients evaluated objectively. Subjectively the patients did not report diminished strength.