Using Periactin for Appetite Stimulation in Pediatric Patients

Indications for the use of Periactin?

You have a one-year-old baby who has recently shown increased signs of milk aversion.
The doctor has prescribed Periactin (to be taken either twice a day or once daily).
It has been noted that Periactin is primarily indicated for rhinitis, allergy treatment, and appetite stimulation.
I would like to ask:
1.
Is it appropriate to use this medication for appetite stimulation for a duration of 1-2 weeks (without any cold symptoms)? Will there be a risk of developing tolerance to the medication during future illnesses?
2.
Since the baby has indeed shown a significant increase in appetite with once-daily dosing (currently weighing 9 kg and measuring 75 cm, which has been stable for a while), how long should this medication be continued, or should it be stopped once the desired effect is achieved and then resumed as needed?

Miss Ye, 30~39 year old female. Ask Date: 2023/04/25

Dr. Xiao Kaiwen reply Pediatrics

Periactin has a short duration of effect with generally minimal adverse effects on the body.
There is no specific duration required for its use (one to two weeks typically does not lead to any negative effects), and there is no issue of drug resistance (which is a concern primarily with antibiotics).
For infants who are reluctant to feed, it is still recommended to focus on supplementing with solid foods and varying the types of food, as medications are only a temporary aid.

Reply Date: 2023/04/25

More Info

Using Periactin (cyproheptadine) as an appetite stimulant in pediatric patients, particularly in infants and young children, is a topic that requires careful consideration. Periactin is an antihistamine that is primarily used to treat allergic reactions, such as hay fever and urticaria, but it is also known for its side effect of increasing appetite. Here, I will address your questions regarding its use in your one-year-old child.

1. Long-term Use of Periactin for Appetite Stimulation: It is generally not recommended to use Periactin for an extended period, such as 1-2 weeks, without medical supervision. While it can stimulate appetite, the long-term effects of using antihistamines in young children are not well-studied. Prolonged use of antihistamines can lead to tolerance, meaning that over time, the same dose may become less effective. Additionally, there is a risk of potential side effects, including sedation, dizziness, and dry mouth. In some cases, children may experience paradoxical reactions, where they become more agitated or hyperactive instead of sedated.
Regarding the concern about developing resistance to the medication, while it is not common for children to develop a true "antibiotic resistance" to antihistamines, their effectiveness may diminish with prolonged use. Therefore, it is crucial to monitor your child's response to the medication and consult with your pediatrician about the duration of treatment.

2. Dosage and Duration of Treatment: If your child is responding well to Periactin and is showing an increase in appetite, it is essential to follow your pediatrician's guidance on how long to continue the medication. In many cases, it may be appropriate to use the medication for a short duration, such as a few days to a week, and then reassess the situation. If the appetite improves, you may consider tapering off the medication and only using it as needed in the future.
It is also important to explore other underlying causes of decreased appetite. Factors such as illness, stress, changes in routine, or even food preferences can affect a child's willingness to eat. Ensuring that your child has a balanced diet and a pleasant eating environment can also help stimulate appetite without the need for medication.

In conclusion, while Periactin can be effective in stimulating appetite in pediatric patients, it should be used judiciously and under the guidance of a healthcare professional. Regular follow-ups with your pediatrician are essential to monitor your child's growth, development, and overall health. If you have concerns about your child's eating habits or the use of medications, do not hesitate to reach out to your healthcare provider for personalized advice and recommendations.

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