FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 293:893-896 October 30, 1975 Number 18 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

Experimental evidence suggests a central-nervous-system origin of Cushing's disease and a role for serotonin in the regulation of ACTH release. The efficacy of cyproheptadine therapy, therefore, was studied in three patients with such disease. Administration of 24 mg daily over a period of three to six months was associated with prompt and sustained clinical and laboratory remission. Lessening of the physical manifestations of hypercorticism occurred, together with marked improvement in muscular weakness. Urinary corticosteroid excretion and cortisol secretory rate returned to normal. The urinary corticosteroid response to dexamethasone (2 mg per day) became normal; a paradoxical increase followed 8 mg per day. Abnormal circadian periodicity of plasma cortisol concentrations persisted. Return of normal amounts of Stage III to IV sleep occurred in the one patient so studied, who previously had markedly decreased periods of these stages. Discontinuance of therapy in one patient was associated with return of laboratory evidence of hypercorticism.

This article has been cited by other articles:

• Watemberg, N. M., Roth, K. S., Alehan, F. K., Epstein, C. E. (1999). Central Anticholinergic Syndrome on Therapeutic Doses of Cyproheptadine. Pediatrics 103: 158-160 [Full Text]  
• Mercado-Asis, L. B., Yanovski, J. A., Tracer, H. L., Chik, C. L., Cutler, G. B. Jr. (1997). Acute Effects of Bromocriptine, Cyproheptadine, and Valproic Acid on Plasma Adrenocorticotropin Secretion in Nelson's Syndrome. J. Clin. Endocrinol. Metab. 82: 514-517 [Abstract] [Full Text]  
• Cook, D. M., McCarthy, P. J. (1988). Failure of Hypophysectomy to Correct Pituitary-Dependent Cushing's Disease in Two Patients. Arch Intern Med 148: 2497-2500 [Abstract]  
• Reith, P., Monnot, E. A., Bathija, P. J. (1987). Prolonged Suppression of a Corticotropin-Producing Bronchial Carcinoid by Oral Bromocriptine. Arch Intern Med 147: 989-991 [Abstract]  
• Burch, W. M. (1985). Cushing's Disease: A Review. Arch Intern Med 145: 1106-1111 [Abstract]  
• ASA, S. L., KOVACS, K., TINDALL, G. T., BARROW, D. L., HORVATH, E., VECSEI, P. (1984). Cushing's Disease Associated with an lntrasellar Gangliocytoma Producing Corticotrophin-Releasing Factor. ANN INTERN MED 101: 789-793 [Abstract]  
• Meltzer, H. Y., Umberkoman-Wiita, B., Robertson, A., Jo Tricou, B., Lowy, M., Perline, R. (1984). Effect of 5-Hydroxytryptophan on Serum Cortisol Levels in Major Affective Disorders: I. Enhanced Response in Depression and Mania. Arch Gen Psychiatry 41: 366-374 [Abstract]  
• Kammer, H., George, R. (1981). Cushing's Disease in a Patient With an Ectopic Pituitary Adenoma. JAMA 246: 2722-2724 [Abstract]  
• SCHTEINGART, D. E., TSAO, H. S., TAYLOR, C. I., MCKENZIE, A., VICTORIA, R., THERRIEN, B. A. (1980). Sustained Remission of Cushing's Disease with Mitotane and Pituitary Irradiation. ANN INTERN MED 92: 613-619 [Abstract]  
• HSU, T.-H. (1980). Management of Virilizing Congenital Adrenal Hyperplasia with Cyproheptadine. ANN INTERN MED 92: 628-630 [Abstract]  
• DOLMAN, L. I. (1979). Cyproheptadine Effects on Pituitary Function. ANN INTERN MED 91: 927-927 [Abstract]  
• Pont, A., Gutierrez-Hartman, A. (1979). Cushing's Disease: Recurrence After a Surgically Induced Remission. Arch Intern Med 139: 938-940 [Abstract]  
• WORTSMAN, J., SOLER, N. G., HIRSCHOWITZ, J. (1979). Cyproheptadine in the Management of the Galactorrhea-Amenorrhea Syndrome. ANN INTERN MED 90: 923-925 [Abstract]  
• GOLD, E. M. (1979). The Cushing Syndromes: Changing Views of Diagnosis and Treatment. ANN INTERN MED 90: 829-844 [Abstract]  
• Prinz, R. A., Brooks, M. H., Lawrence, A. M., Paloyan, E. (1979). The Continued Importance of Adrenalectomy in the Treatment of Cushing's Disease. Arch Surg 114: 481-484 [Abstract]  
• Vaisrub, S. (1978). Cushing's Syndrome--Still a Conundrum. JAMA 240: 865-865 [Abstract]  
• Cohen, K. L., Noth, R. H., Pechinski, T. (1978). Incidence of Pituitary Tumors Following Adrenalectomy: A Long-Term Follow-up Study of Patients Treated for Cushing's Disease. Arch Intern Med 138: 575-579 [Abstract]  
• Hopwood, N. J., Kenny, F. M. (1977). Incidence of Nelson's Syndrome After Adrenalectomy for Cushing's Disease in Children: Results of a Nationwide Survey. Arch Pediatr Adolesc Med 131: 1353-1356 [Abstract]  
• (1976). Endocrinology and Metabolism: An Annotated Bibliography of Recent Literature: References to Journal Articles and Other Papers. ANN INTERN MED 85: 689-695 [Abstract]