Depression due to Combined Dexamethasone and Cyproheptadine abuse for weight gain

Cyproheptadine, an H1 antihistamine, and Dexamethasone, a long-acting steroid, are often misused in combination for addressing self-perceived body image issues and have become a popular but dangerous ‘weight gain cocktail’, often available over the counter without any prescription. This case describes a 25-year-old man who had self-prescribed the above-mentioned drugs in combination to address his self-perceived lean physique. This resulted in a significant weight gain, followed by an abnormal increase in appetite, which affected his daily life. Upon cessation, it resulted in rebound weight changes, depressive features, along with features of corticosteroid withdrawal, which required multidisciplinary management. This case highlights the risk of unsupervised use and self-prescribing of such medications, the role of peer influence in consumption, and the urgent need for regulatory control and awareness regarding the over-the-counter access to such medications.