Kardinal C G, Loprinzi C L, Schaid D J, Hass A C, Dose A M, Athmann L M, Mailliard J A, McCormack G W, Gerstner J B, Schray M F
Alton Ochsner Medical Foundation CCOP, New Orleans, Louisiana.
Cancer. 1990 Jun 15;65(12):2657-62. doi: 10.1002/1097-0142(19900615)65:12<2657::aid-cncr2820651210>3.0.co;2-s.
Anorexia, cachexia, and resultant weight loss are major clinical problems in a substantial proportion of patients with advanced cancer. Effective means of alleviating these problematic symptoms are lacking. Extensive clinical data demonstrate a weight enhancing effect for the serotonin antagonist, cyproheptadine, in several clinical situations. In addition, sound basic research suggests that cyproheptadine may be helpful in patients with cancer anorexia/cachexia. Because of this, the authors performed a randomized, placebo-controlled, double-blinded clinical trial using cyproheptadine, 8 mg orally three times a day in 295 patients with advanced malignant disease. Patients assigned to cyproheptadine had less nausea (P = 0.02), less emesis (P = 0.11), more sedation (P = 0.07), and more dizziness (P = 0.01) than placebo patients. Patients' appetites, measured by serial patient-completed questionnaires, appeared to be mildly enhanced by cyproheptadine. Unfortunately, cyproheptadine did not significantly abate progressive weight loss in these patients with advanced malignant disease; patients assigned to cyproheptadine lost an average of 4.5 pounds per month compared to 4.9 pounds per month for patients assigned to a placebo (P = 0.72).
厌食、恶病质及随之而来的体重减轻是相当一部分晚期癌症患者面临的主要临床问题。目前尚缺乏有效缓解这些问题症状的方法。大量临床数据表明，血清素拮抗剂赛庚啶在多种临床情况下具有增加体重的作用。此外，可靠的基础研究表明，赛庚啶可能对癌症厌食/恶病质患者有帮助。因此，作者开展了一项随机、安慰剂对照、双盲临床试验，对295例晚期恶性疾病患者口服8毫克赛庚啶，每日三次。与服用安慰剂的患者相比，服用赛庚啶的患者恶心症状较轻（P = 0.02），呕吐较少（P = 0.11），镇静作用更强（P = 0.07），头晕更明显（P = 0.01）。通过患者连续填写的问卷测量，赛庚啶似乎使患者食欲略有增强。遗憾的是，赛庚啶并未显著减轻这些晚期恶性疾病患者的进行性体重减轻；服用赛庚啶的患者平均每月体重减轻4.5磅，而服用安慰剂的患者平均每月体重减轻4.9磅（P = 0.72）。
