CYPROHEPTADINE TREATMENT IN CUSHINGS-DISEASE

Cyproheptadine, a nonselective 5-hydroxytryptamine receptor blocking a gent, reduces ACTH and beta-endorphin secretion from the ACTH-producin g tumors. A 35-year-old female suffering from Gushing's disease due to microadenoma of the pituitary gland has been followed since the age o f 15. Subtotal adrenalectomy followed by total adrenalectomy, pituitar y irradiation, and transsphenoidal hypophysectomy, combined with secon d radiotherapy of the pituitary, were unsuccessful in achieving remiss ion of the disease. Remission was achieved with cyproheptadine up to a dosage of 24 mg/day. Every attempt to discontinue cyproheptadine trea tment was accompanied by recurrence of the disease. This is the first case of Gushing's disease in which cyproheptadine treatment has been t he only efficacious therapy for a period of 11 yr. Cyproheptadine may be an alternative long-term therapy for Gushing's disease when other m ethods of treatment fail.