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!