Isolated reports describe delayed hallucinations in a patient taking phenelzine and cyproheptadine, and the rapid re-emergence of depression when cyproheptadine was given to two other patients taking brofaromine or phenelzine.
It would be prudent to monitor for a reduction in efficacy or an adverse response if cyproheptadine is given with any MAOI or RIMA. The manufacturer of cyproheptadine contraindicates concurrent use with MAOIs, however, there appears to be no reason why cyproheptadine cannot be used to treat serotonin syndrome occurring in a patient taking an MAOI.
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