Antihistamine not recommended to gain weight
Social media users wanting to put on pounds fast tout cyproheptadine as a "miracle drug." This is misleading advice; in many countries the antihistamine is only approved to relieve allergies and while taking the medicine can cause weight gain, experts warned this could have serious side effects.
Across Instagram, TikTok and YouTube, women and girls wanting to increase the size of their chests, hips and thighs discuss how they have "tried everything" to gain a few pounds without success until they discovered a "miracle product" which allowed them to go from 110 to 135 pounds in a matter of weeks.
Many say the "secret" is to consume products with the antihistamine cyproheptadine which they say stimulated their appetites and allowed them to gain weight.
On TikTok, the hashtag #cyproheptadine had more than 380,000 views, as of May 8, 2023.
The trend dates back several years, including a TikTok posted on June 16, 2020 with more than 45,000 views.
"That's ALL I did. I have never been able to gain weight. But these two products DEFINITELY showed results and very quickly," says the text over a video of a woman touting a protein shake and Apetamin syrup, a nutritional supplement which contains cyproheptadine, but is an unapproved drug in the United States.
The ingredient cyproheptadine can stimulate the appetite and cause people to gain weight, but its recommended usage has changed over time.
Marie Tardieu, the manager of the allergy medications unit at the ANSM, the French public agency tasked with assessing the safety of drugs, explained that as an antihistamine, cyproheptadine was originally prescribed to relieve allergy symptoms, but received a 1961 approval in France to treat weight loss.
Laurent Chouchana, a clinical pharmacologist at the Cochin-Port-Royal Hospital in Paris said: "There was an indication for 'appetite stimulation in sick people who showed a decrease in appetite, accompanied by weight loss' until 1994, when it was rescinded."
He said the clinical studies researching the balance of risks and benefits of taking the drug to gain weight were "not very robust," which led health authorities to reduce recommendations of cyproheptadine for this use -- first in France, then in Canada and the United States.
Cyproheptadine for weight gain is allowed in Canada, but always under the advice of a physician. Chouchana said the drug was meant to treat weight loss symptoms associated with an illness and not for people in good health.
Some French social media users have encouraged the use of cyproheptadine under its brand name Periactin.
The Cleveland Clinic page (archived here) for Periactin cautions against the side effects of drowsiness, which can impede the use of heavy machinery and be exacerbated with the consumption of alcohol. It also warns of occurrences of blurred vision and does not recommend use if the patient already has glaucoma.
"This is an older medication with well-known, undesirable side effects," Chouchana told AFP on March 31. "Convulsions, hallucinations and a lot of the time, drowsiness, which can lead to accidents, but there are also more serious effects, such as blood, liver and heart problems, especially if there is an overdose."
Trend born in Africa
In some places in Africa, women have been using cyproheptadine to bulk up their figures for a number of years.
One 2011 study (archive) researching the use of cyproheptadine by the Kinshasa population in the Democratic Republic of Congo found 70 percent of women in this group were taking the drug as a nutritional supplement. The researchers also found the study participants were at a higher risk for obesity, especially because many of them were also taking dexamethasone, a corticosteroid for weight gain.
African YouTubers often discuss Apetamin, a nutritional supplement that contains several vitamins, as well as cyproheptadine. Some vloggers will include promotional links to buy Apetamin products.
Apetamin is illegal in many countries -- including France, the United Kingdom and the US -- but people promote Apetamin and similar supplements such as Super Apeti Plus in French, English and Arabic on TikTok.
People living in places where Periactin is only available by prescription turn to the supplement as it is easy to find and buy online.
These types of products are particularly concerning for Chouchana since "it contains a drug, but it isn't sold or controlled as such."
On May 2, 2023, the FDA published a warning (archived here) about the dangers of Apetamin in reaction to the network of recommendations for the product on social media.
Searching for Apetamin on Instagram and TikTok in May 2023 on a US server blocks results with a message about illegal drug use and trade.
Searching for "cyproheptadine" and "Periactin" on TikTok still yields results but among the publications celebrating the drug, there are also users discussing the unwanted side effects.
One TikTok user said: "The only thing I'm doing is waking up, eating, going back to sleep, waking up, eating, going back to sleep."
Chouchana said there are very few cases where it is advisable to take medication for weight loss or gain.
"All drugs carry risks and should not be taken outside of their indication in any medical situation," he said.