Cyproheptadine dependence associated with an atypical somatoform disorder

A case is described of cyproheptadine dependence in a woman with a persistent belief that she was too thin, and diagnosed with an atypical somatoform disorder. The cyproheptadine was initially prescribed to promote weight gain but its continued use seemed related to other psychological and/or pharmacological effects. Cognitive impairment was present, possibly as a result of the longstanding cyproheptadine abuse. There have been no previous reports of cyproheptadine dependence or of CNS toxicity from its long-term use.