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Cyproheptadine is an antihistamine that is commonly used in pets for the treatment of many symptoms, including allergies, loss of appetite, and increased serotonin production associated with Cushing's disease.

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Arm I: Patients receive oral cyproheptadine hydrochloride twice daily for up to 24 weeks in the absence of weight loss or unacceptable toxicity.

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Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders.

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Of the partners who were HIVfree at the start of the study, two in the intervention group and three in the comparison group became HIVpositive during the study.

Advance care planning, patient and caregiver education about dementia, diet and exercise and non-pharmacologic approaches to behavioral issues are integral to the care of patients with dementia, and should be included in the treatment plan in addition to any consideration of a trial of cholinesterase inhibitors.

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