Quantitative assessment of the effect of cyproheptadine on spastic paretic gait: a preliminary study

The effects of cyproheptadine were studied in two patients with spastic paresis. The study consisted of two phases: a control phase (no medication) and a cyproheptadine phase (8 mg t.i.d.). The effects were evaluated from electromyographic (EMG) and kinematic analysis of treadmill walking with a portion of body weight supported, and from clinical examination and subjective assessments. Episodes of spontaneous spasms and elicited clonus were reduced with cyproheptadine. Improvement in locomotor function was evidenced by a decreased cycle duration, more regular foot-floor contact, functional joint excursions, and increased walking speed. In addition, a tonic EMG activity pattern was replaced by phasic muscle activation in the proximal extensors especially. Selective proximal movements were unmasked (hip flexion) and certain functional activities (transfers, dressing) were facilitated. The results support the role of cyproheptadine as an antispastic medication. Study of the short-term and long-term benefits of cyproheptadine is continuing.