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Cyproheptadine hydrochloride is a potent antihistamine with antiserotonin, anticholinergic, and possibly calcium channel - blocking activities. It is effective in the treatment of urticaria and is often prescribed for moderate to severe atopic dermatitis. Clinicians from the Medical College of Virginia described a case of anticholinergic syndrome in a nine-year-old boy prescribed therapeutic doses of cyproheptadine (4 mg; 0.1 mg/kg twice daily) for migraine headaches.
The medication was discontinued after an initial short trial because his behavior became "mean." However, the drug was restarted when his headaches returned. After two weeks of therapy, he experienced an acute episode of agitation progressing to psychosis with visual hallucinat…