Use of cyproheptadine hydrochloride (HCl) to reduce neuromuscular hypertonicity in stroke survivors: A Randomized Trial: Reducing Hypertonicity in Stroke

• Published in: Journal of stroke and cerebrovascular diseases 2022-10, Vol.31 (10), p.106724-106724
• Main Authors: Kamper, Derek, Barry, Alexander, Bansal, Naveen, Stoykov, Mary Ellen, Triandafilou, Kristen, Vidakovic, Lynn, Seo, NaJin, Roth, Elliot
• Format: Article
• Language: English
• Subjects: Cyproheptadine - adverse effects; Humans; Muscle Spasticity - diagnosis; Muscle Spasticity - drug therapy; Muscle Spasticity - etiology; Neuromuscular Agents - therapeutic use; Stroke - complications; Stroke - diagnosis; Stroke - drug therapy; Stroke Rehabilitation; Survivors; Treatment Outcome
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2022.106724

The goal of this study was to examine how the administration and dosing of the anti-serotonergic medication cyproheptadine hydrochloride (HCl) affects involuntary muscle hypertonicity of the spastic and paretic hands of stroke survivors. A randomized, double-blinded, placebo-controlled longitudinal intervention study was performed as a component of a larger clinical trial. 94 stroke survivors with chronic, severe hand impairment, rated as levels 2 or 3 on the Chedoke-McMaster Stroke Assessment Stage of Hand (CMSA-H), were block randomized to groups receiving doses of cyproheptadine HCl or matched doses of placebo. Doses were increased from 4 mg BID to 8 mg TID over 3 weeks. Outcomes were assessed at baseline and after each of the three weeks of intervention. Primary outcome measure was grip termination time; other measures included muscle strength, spasticity, coactivation of the long finger flexors, and recording of potential adverse effects such as sleepiness and depression. 89 participants (receiving cyproheptadine HCl: 44, receiving placebo: 45) completed the study. The Cyproheptadine group displayed significant reduction in grip termination time, in comparison with the Placebo group (p