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Pizotifen is a synthetic small molecule drug primarily used for the prophylactic treatment of migraine and cluster headaches. It acts mainly as an antagonist at serotonin 5-HT2A and 5-HT2C receptors, but also exhibits antihistamine and weak anticholinergic properties. Pizotifen binds non-selectively to several receptor types including serotonin, dopamine, adrenergic, histamine, and muscarinic acetylcholine receptors. Its antimigraine effect is thought to result from inhibition of the peripheral actions of serotonin and histamine on cranial blood vessels as well as modulation of pain thresholds. Pizotifen also has appetite-stimulating effects and is structurally related to cyproheptadine[1][2][6][8].
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