Chronic Migraine, Coping, Treatment

Cyproheptadine for Migraine Prevention

The entire time I’ve been on cyproheptadine (about seven weeks), I’ve alternated between wanting to gush to you about it and feeling an immense need to keep quiet, lest I put its effect in jeopardy. I’m more superstitious about this medication and its efficacy than a starting pitcher in the seventh game of the World Series. I fret over the strangest things, afraid that any change in my symptoms or dose could mean an end to the relief.

Cyproheptadine is not new or novel; in fact, the brand name version, Periactin, is no longer made. It is an old antihistamine often used to children with migraine. I tried it a couple years ago and, although it is known for causing drowsiness and is sometimes used as a sleep aid, it made me jittery and unable to sleep. That first trial lasted only a couple days. This past summer I was so fatigued (turns out I was deficient in vitamins D and B12) that I decided maybe the side effects I experienced on cyproheptadine the first time would be welcome.

This time I had the more typical side effects of drowsiness and increased appetite, but also had an immediate reduction in the severity of migraine pain. The side effects were the strongest the first week I started the medication. I’ve increased the dose twice and each time have noticed the side effects for two or three days before they disappear. So far, I’m two pounds heavier than when I started.

Cyproheptadine’s maximum dose is 36 mg; I’m on 12, where I plan to stay for at least another month to see if I get any further benefit the longer I’m on the dose. For now, I’m enjoying many days where the pain ranges between a level 2 and 4. Only twice in the last month has the pain reached level 6 and I’ve even had a couple hours at level 1. At least, I think it was — I have no memory of what level 1 feels like.

This is the land of rainbows and unicorns!

35 thoughts on “Cyproheptadine for Migraine Prevention”

  1. Hi Emily, I took the same dose for vestibular migraine, which I had for 6 months prior to starting the medication. Worked really well for me too. I was able to cease it after 6 months and in the three years since stopping the medication have not had any recurrence of vestibular symptoms.

  2. Hi Emily, I also had very severe vestibular migraines continuously for about 6 months before I tried this medication, and, like you, it worked well and quickly. After 6 months on it I successfully weaned off it with no recurrence of vertigo. Occasionally it starts up again and I find I can restart it for jyst a week or two and that’s enough to settle things down. I definitely would try coming off it at some point. Easy to restart if needed.

  3. Hello I am a 30 year old female who developed Vestibular Migraines after the birth of my second child. They came on hard and strong. Periactin has been a life saver. I take 4mg a day and have been symptom free for 5 months now. I have put on 8kg so iv started running. I think I the exercise has had a great effect too. I suffered for an entire year with awful symptoms. I’m so glad the second medication the neurologist put me on worked so well. I am curious about how long I can take the medication for? I’m too scarred to ever stop since the results were so immediate and positive for me. Thanks you and good luck to you all!

  4. My 9 year old granddaughter started having migraine headaches last June 2018. The started as once a month and increased until she had them every day. The emergency room doctor at Children’s Hospital prescribed 4 mg of Cyproheptadine daily at bedtime. The prescription has expired and her personal physician refuses to refill it because it has not been approved by the FDA for children. Is that true?

  5. My 7 year old has been taking this for almost 2 months. It has helped so much. His migranes have been happening since he was 2! They were so bad he would wake from a deep sleep and start screaming at the top of his lungs, he has always had vomiting with them as well. His old doctor just kept saying it is his eyes, even though the eye doctor said his eyes are fine. We moved states and his new doctor knew right away what it was and he started out on a single 4mg tablet before bed and he was having about 4 a month so she is now having him take 2, so far he hasn’t had another. Then my husband had me worrying saying we needed to research and make sure this was safe for him to take long term. So, if anyone has info on that, that would be great! He has stated gaining weight so i think we need to plan more outdoor activities to keep him from getting to heavy, weight issues run in my family.

    1. Hi Bridgette, I’m so sorry you’ve had to see your child struggle with migraine from such a young age. That has to be so difficult to see. What great news that you’ve found an effective preventive. I recommend talking with your doctor about long-term side effects. But keep in mind that most people (and especially kids) don’t need to take migraine preventives for more than a couple years. I’m not sure why this doesn’t get talked about more, but it’s like the brain figures out a new pathway from being on the medication and it no longer defaults to migraine. This is especially true for kids, since they haven’t had so many years for migraine patterns to develop in the brain. I wish you and your son all the best. I’m so happy you’ve found an effective treatment for him at such a young age.

      Take care,

  6. My daughter had extreme frontal head pain for 12 days straight. She said it felt like an anvil pounding on her forehead. She is on Periactin and hasn’t had a major headache since 1/16/17. But today she got a small headache and started crying because she was nervous about getting another extreme pounding headache. She is only 8! I do hope and pray Periactin is working. Anyone that young having extreme pain?

    1. Hi Nicole, I’m sorry your daughter is going through this. It must be so hard for both of you. Reading about her fear of another headache, made me think of biofeedback. It’s a behavioral intervention often used for migraine that can help with the anxiety about more attacks–which is very common. I recently described biofeedback as mindfulness with video game-like feedback. It’s often a treatment of choice for children, since it doesn’t require medication. I’m glad to hear your daughter has found some relief with Periactin.

      Take care,

      1. My 11 year old boy is one week 5 of cyproheptadine and unfortunately his migraines have not changed. I was praying this would work but I am devastated that it hasn’t. He has average 8 migraines a month

        1. Hi Joanna, I’m so sorry it hasn’t helped your son. You might want to talk to his doctor about increasing the dose. I have a friend who didn’t respond until she was on the highest dose and it worked great for her. Best wishes to you and your sono.

          Take care,

    2. Hi. My daughter just started this medication 2 weeks ago and she is 6. She’s experienced 2 large migraines before starting the med. After one week she was experiencing a lot of blurry vision. The dr reduced her dose in half. It’s now been day 4 at lower dose and she had a small headache tonight. Has your kid shown any signs of moodiness? My daughter has and I’m trying to decipher if it’s normal mood changes or the medication. Are you satisfied with the med over all?

    3. My daughter is 9 and will be taking her first dose tonight. I am hoping this works because she has had this headache for 3 weeks and nothing else has worked. Her neurologist guaranteed us that it would work. Fingers crossed because I can’t bear to see my daughter like this anymore.

    4. Hi Nicole,

      My daughter who is 8yrs was placed on Periactin last year only half a tablet. We did a trial for 3mths and yes there was still an occasional migraine. We thought we would go off this medication for a couple of months to see what the outcome was but the headaches – migraines have become worse. So now we have just recently gone on Periactin last couple of weeks taking a full tablet at little bit worried as the headaches have become worse so we are off to the GP tomorrow. I was wondering how your daughter is getting on today – thank you!

  7. I am 17 and after a year of doctors scratching their heads I finally was diagnosed 2 weeks ago with abdominal migraines. The periactin (4mg) daily has prevented the episodes which were occurring 3 or 4times a week for the past 5 YEARS! But, I take in the morning since it makes me hyper, not SLEEPY! I’m told I will go on to experience migraine headaches as I get older. Ohjoy.I hope this medicine keeps them at bay!

  8. I’ve just been prescribed it both for migraines and IBS. I am already on Topamax, which worked for a while, but the migraines are getting worse (with associated vomiting), and despite a neurostimulator in my sacrum and watching my diet, the IBS is almost unmanageable. I was excited about it until I read about the weight gain. I’ve already lost a lot of weight and have more I’d like to do. I can’t do heavy exercise due to multiple surgeries, so just wondering about that side of things. Anyway, at this stage I am desperate enough to try anything. Thanks for writing about this amazing drug. Good to hear it is worth trying!

  9. I am taking cycloheptadin 10mg (half a tablet) per day from last year. My doctor said i can take this medicine as long as i need for my whole life. I have chronic gastritis problem too. After using this medicine my apitite increased and i started to feel better with gastritis because of eating most of the time. I gain 5 pounds too. But now i am planning to have baby and want to stop this medicine as it is not clearly known if it is ok to have this medicine during pregnancy. I stopped to take this medicine 1week ago i was fine. But after 1 week i started to have stomach pain, acidity, fullness of stomach and bloating and i loss apitite too. I am confused that was this medicine helping me for my gastic problem and migration both? And what should i do now. Is it ok to tke this medicine life long?? Or how long is ok?? Please anybody who have an idea about it…i need suggestions. …

  10. I stumbled across your article when I googled cyproheptadine. I’ve just started and am also cautiously hoping it will help my daily headaches. How quickly did you dose up to 12 mg?

  11. I went off of the Cyproheptadine. It put 25 lbs on me in 2 months and didn’t help with the headaches.

    I have since lost the weight but had to go on a medical weight loss plan. I am just starting Lyrica.


  12. My neurologist has me on cyproheptadine. I am on 4mg currently and it hasn’t helped. I have been trying for six years for a medication that works to prevent or treat my migraines. I have migraines almost everyday. Are there any medications that you have had luck to prevent or treat migraines?

  13. Entirely relate to the superstitious thing it’s what I do too. Fingers and toes crossed for you! Great website. Got on to Cyproheptadine via Migraine Trust. Just about to look for a supply here in the Land Of Oz! Keep up the great work.

  14. If Periactin helps a child’s migraines, would Claritin also help?… would make more sense if you could give the child Periactin at night and Claritan during the day.

  15. I have been on 12 MG per night for two weeks. So far it’s fantastic! first relief I’ve had in four years of horrible headaches nearly daily. I also take coffee and two advil if I feel even a tinge of pain it works.

    1. Paula,

      Are you still on this med? I have just started at a low dose – I am in year 4 of daily headaches that are getting worse as time goes on.

      I have hopes reading this article and these comments.


    1. Barbie, I take 12 mg in the evening, which is a fairly low dose. I tried going to 16 mg, but it’s a migraine trigger for me at that dose.

      Take care,

  16. Yabadoo – great to hear from another migraineur, that antihistamines work well :-))
    I’m on my 5th year now with Sandomigran and it still helps me.

    Thanx for all your posts on magnesium! It saves me from nasty rebound headaches.

  17. I am so so so happy for you! I haven’t heard of that medication before.. hmmm Anyway, I’m thrilled that you’re seeing improvements.

  18. Thanks for the quiet, cautious celebration!

    And you make a great point, Victoria. I forgot to mention in the post that I’ve tried three dozen medications and supplements to no avail. Many people think they’ve tried everything after three or four meds. Oh no, there are many more options and you never know which one will work.

    Take care,

  19. doing a tentative whoop whoop for you!! Also a very good advert for showing that just because a preventative didn’t work in the past doesn’t mean it’s not worth another go – and that sometimes it can be worth sticking out bearable side effects I guess! Fingers and toes crossed for you!!

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