LETTER
Prinzmetal Angina and Cyproheptadine
Julian L. Ambrus
15 January 1995 | Volume 122 Issue 2 | Page 155
TO THE EDITOR:
Schecter and colleagues [1] reported that a subset of patients with Prinzmetal angina who were refractory to nitrites and calcium channel blockers responded to the antiserotonergic agent cyproheptadine. Little information is available on the mechanisms of action involved or on why some other antiserotonergic agents were inactive in this disorder.
In an earlier study [2], we found that cyproheptadine substantially inhibited platelet aggregation in vivo, ex vivo, and in vitro. It inhibited both serotonin and adenosine diphosphate-induced aggregation. The agent also has antihistamine activity. Inhibition of platelet aggregation may break the vicious cycle in which serotonin is released from aggregating platelets on arteriosclerotic plaques causing more platelet aggregation and more serotonin release. These relatively high concentrations of serotonin then interact with arteriosclerosis-altered vascular walls, thus causing vasospasm.
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Author and Article Information
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Buffalo General Hospital, Buffalo, NY 14203. Mount Sinai Medical
1. Schecter AD, Chesebro JH, Fuster V. Refractory Prinzmetal angina treated with cyproheptadine. Ann Intern Med. 1994; 121:113-4.
2. Ambrus JL, Ambrus CM, Thurber LE. Study of platelet aggregation in vivo. V. Effect of the antiserotonin agent cyproheptadine. J Med. 1977; 8:287-94.
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