塞浦西他啶

**塞浦西他啶**
临床资料
读音	(/ˌsaɪproʊˈhɛptədiːn/
商品名（英语：Drug nomenclature）	Periactin, others
AHFS/Drugs.com	Monograph
MedlinePlus	a682541
核准状况	美 DailyMed: Cyproheptadine;
怀孕分级	澳: A ; ;
给药途径	Oral
ATC码	R06AX02 (WHO) ;
法律规范状态
法律规范	澳：限药剂师（S3）; 加：OTC; 英：一般销售列表 (GSL, OTC); 美：处方药（℞-only）; OTC;
药物动力学数据
血浆蛋白结合率	96 to 99%
药物代谢	Hepatic, mostly CYP3A4 mediated.
生物半衰期	8.6 hours
排泄途径	粪便 (2–20%; of which, 34% as unchanged drug) 与肾 (40%; none as unchanged drug)
识别信息
	IUPAC命名法 4-(5H-Dibenzo[a,d]cyclohepten-5-ylidene)-1-methylpiperidine; ;
CAS号	129-03-3 ; 969-33-5（盐酸盐）
PubChem CID	2913;
IUPHAR/BPS	277;
DrugBank	DB00434 ;
ChemSpider	2810 ;
UNII	2YHB6175DO;
KEGG	D07765 ;
ChEBI	CHEBI:4046 ;
ChEMBL	ChEMBL516 ;
CompTox Dashboard（英语：CompTox Chemicals Dashboard） (EPA)	DTXSID8022872 ;
ECHA InfoCard	100.004.482
化学信息
化学式	C21H21N
摩尔质量	287.41 g·mol−1
3D模型（JSmol（英语：JSmol））	交互式图像;
	SMILES c43\C(=C1/CCN(C)CC1)c2ccccc2\C=C/c3cccc4;
	InChI InChI=1S/C21H21N/c1-22-14-12-18(13-15-22)21-19-8-4-2-6-16(19)10-11-17-7-3-5-9-20(17)21/h2-11H,12-15H2,1H3 ; Key:JJCFRYNCJDLXIK-UHFFFAOYSA-N ;

塞浦西他啶（Cyproheptadine），或名赛庚啶 ，是第一代抗组织胺药，具有抗乙酰胆碱和局部麻醉的功能，也是儿童抗过敏药水希普利敏的主要成分。

它于1959年获得专利，并于1961年用于医疗使用。^[5]

医疗使用[编辑]

塞浦西他啶用于治疗过敏反应 (特别是花粉症).^[6] 用于此目的证实有效，但是第二代抗组织胺药像是酮替酚与氯雷他定也有相同的结果，且副作用较少。^[7]
它也被用作偏头痛的预防性治疗。在2013年的一项研究中，开始治疗后7至10天内，患者的偏头痛发生率显著降低。这些患者在服药前偏头痛发作的平均频率为每月8.7次，开始治疗后3个月降至每月3.1次。^[7]^[8] 在英国和其他一些国家/地区，药品仿单上有此用法。
它也被药品“仿单核准适应症外的使用”在婴儿周期性呕吐症候群（英语：cyclical vomiting syndrome）的治疗。这种用途的唯一证据来自回顾性研究。^[9]
塞浦西他啶有时被“仿单核准适应症外的使用”，以改善服用抗精神病药物的患者的静坐不能。^[10]
它也被药品“仿单核准适应症外的使用”于治疗各种皮肤病，包括精神性搔痒症（英语：psychogenic pruritus）|^[11]、药物诱发的多汗症（出汗过多）^[12]，以及预防表浅性单纯性水疱性表皮松解症（英语：Epidermolysis bullosa simplex）的水疱形成。^[13]
该药物的作用之一是食欲增加和体重增加，这导致该药物在消瘦的儿童以及囊肿性纤维化患者中用于此目的（在美国为“仿单核准适应症外的使用”）。^[14]^[15]^[16]
它也使用在“仿单核准适应症外的使用”治疗中度至重度血清素综合症，与使用血清素类（英语：serotonergic）药物有关的复杂症状，像是选择性5-羟色胺再摄取抑制剂 (与单胺氧化酶抑制剂)，以及在血清素产生的类癌肿瘤导致血液中5-羟色胺升高的案例。^[17]^[18]

副作用[编辑]

副作用包括：^[3]^[4]

镇静和困倦（通常是短暂的）Sedation and sleepiness (often transient)
头晕 Dizziness
协调不佳 Disturbed coordination
混乱 Confusion
躁动不安 Restlessness
兴奋 Excitation
紧张 Nervousness
震颤 Tremor
易怒 Irritability
失眠 Insomnia
感觉异常 Paresthesias
神经炎 Neuritis
抽搐 Convulsions
欣快感 Euphoria
幻觉 Hallucinations
歇斯底里 Hysteria
模糊 Faintness
皮疹和水肿的过敏表现 Allergic manifestation of rash and edema
发汗 Diaphoresis
荨麻疹 Urticaria
对光敏感 Photosensitivity
急性迷路炎 Acute labyrinthitis
复视（双眼） Diplopia (seeing double)
眩晕 Vertigo
耳鸣 Tinnitus
低血压 Hypotension (low blood pressure)
心悸 Palpitation
期前收缩 Extrasystoles
过敏性休克 Anaphylactic shock
溶血性贫血 Hemolytic anemia
诸如白细胞减少症，粒细胞缺乏症和血小板减少症等血液异常 Blood dyscrasias such as leukopenia, agranulocytosis and thrombocytopenia
胆汁淤积 Cholestasis
对肝脏的影响：
- 肝炎 Hepatitis
- 黄疸 Jaundice
- 肝功能衰竭 Hepatic failure^[19]
- 肝功能异常 Hepatic function abnormality
上腹窘迫 Epigastric distress
食欲不振 Anorexia
恶心 Nausea
呕吐 Vomiting
腹泻 Diarrhea
抗胆碱能副作用:
- 视力模糊 Blurred vision
- 便秘 Constipation
- 口腔干燥症（口干） Xerostomia (dry mouth)
- 心动过速（高心率）Tachycardia (high heart rate)
- 尿潴留 Urinary retention
- 排尿困难 Difficulty passing urine
- 鼻塞 Nasal congestion
- 鼻或喉咙干燥 Nasal or throat dryness
频尿 Urinary frequency
早期月经 Early menses
支气管分泌物增厚 Thickening of bronchial secretions
胸闷气喘 Tightness of chest and wheezing
疲劳 Fatigue
寒意 Chills
头痛 Headache
食欲增加 Increased appetite
体重增加 Weight gain

用药过量[编辑]

过量使用时，有时建议使用活性炭进行洗胃。这些症状通常表明中枢神经系统抑制（或在某些情况下相反地刺激中枢神经系统）和过度的抗胆碱能副作用。小鼠的半数致死量(LD₅₀)为 123 mg/kg，，大鼠的半数致死量为 295 mg/kg 。^[3]^[4]

药理[编辑]

药效学[编辑]

塞浦西他啶对此表列出的所有受体均表现为拮抗剂或逆向激动剂。^[20]

塞浦西他啶^[20]
Site	K_i (nM)^[a]	Action^[b]	Species
H₁	0.06	↓	Human
H₂	ND		ND
H₃	>10,000		Human
H₄	202		Human
M₁	12	↓	Human
M₂	7	↓	Human
M₃	12	↓	Human
M₄	8	↓	Human
M₅	11.8	↓	Human
5-HT_1A	59		Human
5-HT_2A	1.67	↓	Human
5-HT_2B	1.54	↓	Human
5-HT_2C	2.23	↓	Human
5-HT₃	228		Mouse
5-HT₆	142		Human
5-HT₇	123		Human
D₁	117		Human
D₂	112	↓	Human
D₃	8		Human
SERT	4,100		Rat
NET	290		Rat
DAT	ND		ND
^ 平衡常数越小，药物与位点的结合越强。 ^ ↑促效剂 ↓抗拮剂

塞浦西他啶是一种非常有效的抗组胺药或H₁受体的拮抗剂。它在较高浓度下还具有抗胆碱能、抗血清素能和抗多巴胺能活性。它是5-HT₂受体的强效拮抗剂，这是其治疗血清素综合症的基础。

塞浦西他啶具有较弱的的抗雄激素活性。^[21]

药物代谢动力学[编辑]

塞浦西他啶口服后吸收良好，血浆浓度峰值出现在1至3小时后。^[22]口服塞浦西他啶的生物半衰期约为8小时。^[2]

化学[编辑]

塞浦西他啶是三环（英语：Tricyclic）苯并环庚烯（英语：Benzocycloheptene），与吡唑替芬（英语：Pizotifen）和酮替酚以及三环抗抑郁药密切相关。

研究[编辑]

在一项规模较小的精神分裂症患者中，辅助使用塞浦西他啶作为辅助治疗，该患者的病情稳定且正在接受其他药物治疗。虽然注意力和口语流利性似乎有所改善，但这项研究规模太小，不足以概括。^[23]在另两项针对精神分裂症患者的试验中，也已对其进行了佐剂研究，总共约有50人，并且似乎没有效果。^[24]

已经进行了一些试验，以观察塞浦西他啶是否可以减轻SSRI和抗精神病药引起的性功能障碍。^[25]

塞浦西他啶已被研究用于创伤后压力症候群（PTSD）。^[24]

兽医用途[编辑]

塞浦西他啶使用在猫的食欲刺激剂（英语：appetite stimulant）^[26] ，也可作为哮喘的辅助治疗剂。^[27] 可能的副作用包括刺激和攻击行为。^[28]它在猫的生物半衰期为 12 小时。^[27]

塞浦西他啶也用在马的垂体中间部功能障碍（英语：pituitary pars intermedia dysfunction）的二线治疗。^[29]^[30]

参考资料[编辑]

^ Cyproheptadine. Dictionary.com Unabridged. Random House.
^ ^2.0 ^2.1 Gunja N, Collins M, Graudins A. A comparison of the pharmacokinetics of oral and sublingual cyproheptadine. Journal of Toxicology. Clinical Toxicology. 2004, 42 (1): 79–83. PMID 15083941. S2CID 20196551. doi:10.1081/clt-120028749.
^ ^3.0 ^3.1 ^3.2 ^3.3 CYPROHEPTADINE HYDROCHLORIDE tablet [Boscogen, Inc.]. DailyMed. Boscogen, Inc. November 2010 [26 October 2013]. （原始内容 (PDF)存档于2013-07-04）.
^ ^4.0 ^4.1 ^4.2 ^4.3 PRODUCT INFORMATION PERIACTIN® (cyproheptadine hydrochloride) (PDF). Aspen Pharmacare Australia. Aspen Pharmacare Australia Pty Ltd. 17 November 2011 [26 October 2013]. （原始内容 (PDF)存档于29 October 2013）.
^ Fischer, Jnos; Ganellin, C. Robin. Analogue-based Drug Discovery. John Wiley & Sons. 2006: 547 [2020-12-15]. ISBN 9783527607495. （原始内容存档于2021-08-29）（英语）.
^ MedlinePlus Drug Information: Cyproheptadine. [2020-12-15]. （原始内容存档于2008-10-01）.
^ ^7.0 ^7.1 De Bruyne, P; Christiaens, T; Boussery, K; Mehuys, E; Van Winckel, M. Are antihistamines effective in children? A review of the evidence. Archives of Disease in Childhood. January 2017, 102 (1): 56–60. PMID 27335428. S2CID 21185048. doi:10.1136/archdischild-2015-310416.
^ Saito, Y; Yamanaka, G; Shimomura, H; Shiraishi, K; Nakazawa, T; Kato, F; Shimizu-Motohashi, Y; Sasaki, M; Maegaki, Y. Reconsideration of the diagnosis and treatment of childhood migraine: A practical review of clinical experiences. Brain & Development. May 2017, 39 (5): 386–394. PMID 27993427. S2CID 34703034. doi:10.1016/j.braindev.2016.11.011.
^ Salvatore, S; Barberi, S; Borrelli, O; Castellazzi, A; Di Mauro, D; Di Mauro, G; Doria, M; Francavilla, R; Landi, M; Martelli, A; Miniello, VL; Simeone, G; Verduci, E; Verga, C; Zanetti, MA; Staiano, A; SIPPS Working Group on, FGIDs. Pharmacological interventions on early functional gastrointestinal disorders. Italian Journal of Pediatrics. 16 July 2016, 42 (1): 68. PMC 4947301 . PMID 27423188. doi:10.1186/s13052-016-0272-5.
^ Taylor, David; Paton, Carol; Kapur, Shitij. The Maudsley Prescribing Guidelines in Psychiatry. John Wiley & Sons. 2015: 85 [2020-12-15]. ISBN 9781118754573. （原始内容存档于2021-08-28）（英语）.
^ Szepietowski, JC; Reszke, R. Psychogenic Itch Management 50. 2016: 124–32. ISBN 978-3-318-05888-8. PMID 27578081. doi:10.1159/000446055. |journal=被忽略 (帮助)
^ Ashton AK, Weinstein WL. Cyproheptadine for drug-induced sweating. American Journal of Psychiatry. May 2002, 159 (5): 874–5 [2020-12-15]. PMID 11986151. doi:10.1176/appi.ajp.159.5.874-a. （原始内容存档于2012-03-19）.
^ Pfendner, Ellen G.; Bruckner, Anna L. Epidermolysis Bullosa Simplex. GeneReviews. October 13, 2016 [2020-12-15]. PMID 20301543. （原始内容存档于2020-10-22）.
^ Ciproheptadina, estimulante del apetito (Cyproheptadine, appetite stimulant). [2020-12-15]. （原始内容存档于2020-10-24）.
^ Bioplex NF. [2020-12-15]. （原始内容存档于2018-04-18）.
^ Harrison ME, Norris ML, Robinson A, Spettigue W, Morrissey M, Isserlin L. Use of cyproheptadine to stimulate appetite and body weight gain: A systematic review.. Appetite. 2019, 137: 62–72. PMID 30825493. S2CID 72333631. doi:10.1016/j.appet.2019.02.012.
^ Rossi, S (编). Australian Medicines Handbook 2013. Adelaide: The Australian Medicines Handbook Unit Trust. 2013. ISBN 978-0-9805790-9-3.
^ Iqbal, MM; Basil, MJ; Kaplan, J; Iqbal, MT. Overview of serotonin syndrome. Annals of Clinical Psychiatry. November 2012, 24 (4): 310–8. PMID 23145389.
^ Chertoff, Jason. Cyproheptadine-Induced Acute Liver Failure. ACG Case Reports Journal. 8 July 2014, 1 (4): 212–213. PMC 4286888 . PMID 25580444. doi:10.14309/crj.2014.56.
^ ^20.0 ^20.1 Roth, BL; Driscol, J. PDSP K_i Database. Psychoactive Drug Screening Program (PDSP). University of North Carolina at Chapel Hill and the United States National Institute of Mental Health. [14 August 2017]. （原始内容存档于2021-08-28）.
^ Pucci E, Petraglia F. Treatment of androgen excess in females: yesterday, today and tomorrow. Gynecol. Endocrinol. December 1997, 11 (6): 411–33. PMID 9476091. doi:10.3109/09513599709152569.
^ Lindsay Murray; Frank Daly; David McCoubrie; Mike Cadogan. Toxicology Handbook. Elsevier Australia. 15 January 2011: 388 [27 November 2011]. ISBN 978-0-7295-3939-5. （原始内容存档于2014-01-01）.
^ Buoli, M; Altamura, AC. May non-antipsychotic drugs improve cognition of schizophrenia patients?. Pharmacopsychiatry. March 2015, 48 (2): 41–50. PMID 25584772. doi:10.1055/s-0034-1396801.
^ ^24.0 ^24.1 Dabaghzadeh, F; Khalili, H; Ghaeli, P; Dashti-Khavidaki, S. Potential benefits of cyproheptadine in HIV-positive patients under treatment with antiretroviral drugs including efavirenz. Expert Opinion on Pharmacotherapy. December 2012, 13 (18): 2613–24. PMID 23140169. S2CID 25769557. doi:10.1517/14656566.2012.742887.
^ Nunes, LV; Moreira, HC; Razzouk, D; Nunes, SO; Mari Jde, J. Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review. Journal of Sex & Marital Therapy. 2012, 38 (3): 281–301. PMID 22533871. S2CID 23406005. doi:10.1080/0092623X.2011.606883.
^ Agnew, W; Korman, R. Pharmacological appetite stimulation: rational choices in the inappetent cat. Journal of Feline Medicine and Surgery. September 2014, 16 (9): 749–56. PMID 25146662. S2CID 37126352. doi:10.1177/1098612X14545273.
^ ^27.0 ^27.1 Dowling PM. Systemic Therapy of Airway Disease: Cyproheptadine. Kahn CM, Line S, Aiello SE (编). The Merck Veterinary Manual 9th. John Wiley & Sons. February 8, 2005 [2022-06-16]. ISBN 978-0-911910-50-6. （原始内容存档于2016-03-04）. Retrieved on October 26, 2008.
^ Dowling PM. Drugs Affecting Appetite. Kahn CM, Line S, Aiello SE (编). The Merck Veterinary Manual 9th. John Wiley & Sons. February 8, 2005 [2022-06-16]. ISBN 978-0-911910-50-6. （原始内容存档于2012-10-28）. Retrieved on October 26, 2008.
^ Durham, AE. Therapeutics for Equine Endocrine Disorders. The Veterinary Clinics of North America. Equine Practice. April 2017, 33 (1): 127–139. PMID 28190613. doi:10.1016/j.cveq.2016.11.003.
^ Merck Vet Manual. Hirsutism Associated with Adenomas of the Pars Intermedia. [April 24, 2011]. （原始内容存档于2016-03-03）.

#invoke:navbox

[21] 平衡常数越小，药物与位点的结合越强。

[22] 
↑促效剂
↓抗拮剂

[3] 促效剂

[4] ↓抗拮剂

[1] Cyproheptadine. Dictionary.com Unabridged. Random House.

[pmid15083941-2] 2.0 ^2.1 Gunja N, Collins M, Graudins A. A comparison of the pharmacokinetics of oral and sublingual cyproheptadine. Journal of Toxicology. Clinical Toxicology. 2004, 42 (1): 79–83. PMID 15083941. S2CID 20196551. doi:10.1081/clt-120028749.

[DM-3] 3.0 ^3.1 ^3.2 ^3.3 CYPROHEPTADINE HYDROCHLORIDE tablet [Boscogen, Inc.]. DailyMed. Boscogen, Inc. November 2010 [26 October 2013]. （原始内容 (PDF)存档于2013-07-04）.

[TGA-4] 4.0 ^4.1 ^4.2 ^4.3 PRODUCT INFORMATION PERIACTIN® (cyproheptadine hydrochloride) (PDF). Aspen Pharmacare Australia. Aspen Pharmacare Australia Pty Ltd. 17 November 2011 [26 October 2013]. （原始内容 (PDF)存档于29 October 2013）.

[Fis2006-5] Fischer, Jnos; Ganellin, C. Robin. Analogue-based Drug Discovery. John Wiley & Sons. 2006: 547 [2020-12-15]. ISBN 9783527607495. （原始内容存档于2021-08-29）（英语）.

[6] MedlinePlus Drug Information: Cyproheptadine. [2020-12-15]. （原始内容存档于2008-10-01）.

[DeBruyne2017-7] 7.0 ^7.1 De Bruyne, P; Christiaens, T; Boussery, K; Mehuys, E; Van Winckel, M. Are antihistamines effective in children? A review of the evidence. Archives of Disease in Childhood. January 2017, 102 (1): 56–60. PMID 27335428. S2CID 21185048. doi:10.1136/archdischild-2015-310416.

[8] Saito, Y; Yamanaka, G; Shimomura, H; Shiraishi, K; Nakazawa, T; Kato, F; Shimizu-Motohashi, Y; Sasaki, M; Maegaki, Y. Reconsideration of the diagnosis and treatment of childhood migraine: A practical review of clinical experiences. Brain & Development. May 2017, 39 (5): 386–394. PMID 27993427. S2CID 34703034. doi:10.1016/j.braindev.2016.11.011.

[9] Salvatore, S; Barberi, S; Borrelli, O; Castellazzi, A; Di Mauro, D; Di Mauro, G; Doria, M; Francavilla, R; Landi, M; Martelli, A; Miniello, VL; Simeone, G; Verduci, E; Verga, C; Zanetti, MA; Staiano, A; SIPPS Working Group on, FGIDs. Pharmacological interventions on early functional gastrointestinal disorders. Italian Journal of Pediatrics. 16 July 2016, 42 (1): 68. PMC 4947301 . PMID 27423188. doi:10.1186/s13052-016-0272-5.

[Maudsley-10] Taylor, David; Paton, Carol; Kapur, Shitij. The Maudsley Prescribing Guidelines in Psychiatry. John Wiley & Sons. 2015: 85 [2020-12-15]. ISBN 9781118754573. （原始内容存档于2021-08-28）（英语）.

[11] Szepietowski, JC; Reszke, R. Psychogenic Itch Management 50. 2016: 124–32. ISBN 978-3-318-05888-8. PMID 27578081. doi:10.1159/000446055. |journal=被忽略 (帮助)

[12] Ashton AK, Weinstein WL. Cyproheptadine for drug-induced sweating. American Journal of Psychiatry. May 2002, 159 (5): 874–5 [2020-12-15]. PMID 11986151. doi:10.1176/appi.ajp.159.5.874-a. （原始内容存档于2012-03-19）.

[13] Pfendner, Ellen G.; Bruckner, Anna L. Epidermolysis Bullosa Simplex. GeneReviews. October 13, 2016 [2020-12-15]. PMID 20301543. （原始内容存档于2020-10-22）.

[14] Ciproheptadina, estimulante del apetito (Cyproheptadine, appetite stimulant). [2020-12-15]. （原始内容存档于2020-10-24）.

[15] Bioplex NF. [2020-12-15]. （原始内容存档于2018-04-18）.

[cyapp-16] Harrison ME, Norris ML, Robinson A, Spettigue W, Morrissey M, Isserlin L. Use of cyproheptadine to stimulate appetite and body weight gain: A systematic review.. Appetite. 2019, 137: 62–72. PMID 30825493. S2CID 72333631. doi:10.1016/j.appet.2019.02.012.

[AMH-17] Rossi, S (编). Australian Medicines Handbook 2013. Adelaide: The Australian Medicines Handbook Unit Trust. 2013. ISBN 978-0-9805790-9-3.

[18] Iqbal, MM; Basil, MJ; Kaplan, J; Iqbal, MT. Overview of serotonin syndrome. Annals of Clinical Psychiatry. November 2012, 24 (4): 310–8. PMID 23145389.

[19] Chertoff, Jason. Cyproheptadine-Induced Acute Liver Failure. ACG Case Reports Journal. 8 July 2014, 1 (4): 212–213. PMC 4286888 . PMID 25580444. doi:10.14309/crj.2014.56.

[PDSP-20] 20.0 ^20.1 Roth, BL; Driscol, J. PDSP K_i Database. Psychoactive Drug Screening Program (PDSP). University of North Carolina at Chapel Hill and the United States National Institute of Mental Health. [14 August 2017]. （原始内容存档于2021-08-28）.

[pmid9476091-23] Pucci E, Petraglia F. Treatment of androgen excess in females: yesterday, today and tomorrow. Gynecol. Endocrinol. December 1997, 11 (6): 411–33. PMID 9476091. doi:10.3109/09513599709152569.

[MurrayDaly2011-24] Lindsay Murray; Frank Daly; David McCoubrie; Mike Cadogan. Toxicology Handbook. Elsevier Australia. 15 January 2011: 388 [27 November 2011]. ISBN 978-0-7295-3939-5. （原始内容存档于2014-01-01）.

[25] Buoli, M; Altamura, AC. May non-antipsychotic drugs improve cognition of schizophrenia patients?. Pharmacopsychiatry. March 2015, 48 (2): 41–50. PMID 25584772. doi:10.1055/s-0034-1396801.

[Dabaghzadeh2012-26] 24.0 ^24.1 Dabaghzadeh, F; Khalili, H; Ghaeli, P; Dashti-Khavidaki, S. Potential benefits of cyproheptadine in HIV-positive patients under treatment with antiretroviral drugs including efavirenz. Expert Opinion on Pharmacotherapy. December 2012, 13 (18): 2613–24. PMID 23140169. S2CID 25769557. doi:10.1517/14656566.2012.742887.

[27] Nunes, LV; Moreira, HC; Razzouk, D; Nunes, SO; Mari Jde, J. Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review. Journal of Sex & Marital Therapy. 2012, 38 (3): 281–301. PMID 22533871. S2CID 23406005. doi:10.1080/0092623X.2011.606883.

[28] Agnew, W; Korman, R. Pharmacological appetite stimulation: rational choices in the inappetent cat. Journal of Feline Medicine and Surgery. September 2014, 16 (9): 749–56. PMID 25146662. S2CID 37126352. doi:10.1177/1098612X14545273.

[MVM2-29] 27.0 ^27.1 Dowling PM. Systemic Therapy of Airway Disease: Cyproheptadine. Kahn CM, Line S, Aiello SE (编). The Merck Veterinary Manual 9th. John Wiley & Sons. February 8, 2005 [2022-06-16]. ISBN 978-0-911910-50-6. （原始内容存档于2016-03-04）. Retrieved on October 26, 2008.

[MVM1-30] Dowling PM. Drugs Affecting Appetite. Kahn CM, Line S, Aiello SE (编). The Merck Veterinary Manual 9th. John Wiley & Sons. February 8, 2005 [2022-06-16]. ISBN 978-0-911910-50-6. （原始内容存档于2012-10-28）. Retrieved on October 26, 2008.

[31] Durham, AE. Therapeutics for Equine Endocrine Disorders. The Veterinary Clinics of North America. Equine Practice. April 2017, 33 (1): 127–139. PMID 28190613. doi:10.1016/j.cveq.2016.11.003.

[32] Merck Vet Manual. Hirsutism Associated with Adenomas of the Pars Intermedia. [April 24, 2011]. （原始内容存档于2016-03-03）.

[1]

[3]

[4]

[2]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[a]

[b]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]