Cyproheptadine and Growth

Sir.—It is well known that cyproheptadine hydrochloride (an antihistamine with serotonin-antagonistic activity) has an appetite-stimulating effect and promotes weight gain.^{1, 2} However, its effect in promoting linear growth in association with weight gain often seems to be overlooked although it has been documented.^3-5 We therefore wish to report our observations during 29 months of cyproheptadine administration in a small-for-gestational-age female infant to reemphasize the usefulness of this low-cost drug therapy for growth enhancement.

Patient Report.—A 4-year-old girl had been born normally to a 28-year-old woman after a 40-week gestational period. The infant's birth weight had been 2.32 kg (<third percentile); length, 45 cm (<third percentile); and head circumference, 29 cm (<third percentile). The cause of intrauterine growth retardation was unknown. There were no anomalies, and psychomotor development was entirely normal. The patient had no remarkable feeding problems, but her appetite was low.

At the age of 1