APPETIZERS – INTRODUCTION
Appetite-enhancing drugs are a diverse group of medications given to prevent undesired weight loss in the elderly and in patients suffering from such diseases as AIDS and cancer, which often result in wasting of the body’s muscle tissue as well as overall weight loss. The medical term for these drugs is orexigenic, which is derived from the Greek word for “appetite” or “desire.” None of the orexigenic drugs in common use as of 2005, however, were originally formulated or prescribed as appetite stimulants; they range from antihistamines and antiemetics (drugs given to treat or prevent nausea and vomiting) to antidepressants and synthetic hormones. The medications most often used in the early 2000s include mirtazapine (Remeron), a tetracyclic antidepressant; cyproheptadine (Periactin), an antihistamine; dronabinol (Marinol, THC), an antiemetic; nandrolone, oxymetholone, and oxandrolone (Anadrol-50, Durabolin, Hybolin, Oxandrin, and other brand nam! es), which are anabolic steroids related to the male sex hormone testosterone; and megestrol acetate (Megace), a synthetic derivative of the female sex hormone progesterone. In addition to these prescription drugs, fish oil (eicosapentaenoic acid or EPA) has been recommended as an alternative or complementary treatment for undesired weight loss.
APPETIZERS – INDICATION
Appetite stimulant is a drug, hormone, or compound that increases appetite. Appetizers increases hunger and therefore enhances food consumption.
APPETIZERS – INFORMATION
Orexigenic drugs used in the United States as of 2005 are classified as follows:
Mirtazapine. Mirtazapine is a tetracyclic antidepressant that was approved by the Food and Drug Administration (FDA) in 1996 for the treatment of major depression. Although researchers do not fully understand why mirtazapine relieves mood disorders, they think that it increases the levels of noradrenaline and serotonin (chemicals that transmit nerve impulses across the gaps between cells) in the brain. Mirtazapine is most often prescribed as an appetite stimulant for patients who have been previously diagnosed with depression.
Cyproheptadine is an antihistamine given to relieve the symptoms of colds, nasal allergies, and hay fever. It is also prescribed to relieve the itching associated with insect bites and stings, poison ivy, and poison oak. It appears to be most effective in treating loss of appetite in children and adults diagnosed with cystic fibrosis.
Dronabinol is a synthetic version of tetrahydrocannabinol (THC), the mood-altering compound found in marijuana (Cannabis sativa). Marijuana has been known as an appetite stimulant for centuries, having been recommended for that purpose by Ayurvedic practitioners and by the Arabic physician Al Badri, who first described its orexigenic properties in 1251. Dronabinol is most commonly used to treat the nausea and vomiting associated with AIDS and with cancer chemotherapy.
These drugs are given to older persons to increase muscle mass and strength, or to help patients recovering from severe illness or injury to regain lost weight.
Megestrol acetate was first approved by the FDA in 1976 for palliative treatment of metastatic breast or endometrial cancer. It received additional approval in 1993 for the treatment of anorexia or unexplained weight loss in patients with AIDS. Researchers do not fully understand how the drug prevents the growth of cancer cells or how it stimulates appetite.
Fish oil is recommended by some practitioners as a nutritional supplement for weight loss caused by cancer or AIDS. It is thought that the omega-3 fatty acids in fish oil help to reduce the inflammation associated with some forms of cancer therapy as well as helping patients regain lost weight. Although some studies question the effectiveness of fish oil as a complementary treatment for undesired weight loss, the National Center for Complementary and Alternative Medicine (NCCAM) is recruiting patients as of April 2005 for a clinical trial of fish oil as a dietary supplement to maintain weight in patients with pancreatic cancer. The study will be completed in September 2007.
Anabolic steroids — A group of drugs derived from the male sex hormone testosterone, most commonly prescribed to promote growth or to help the body repair tissues weakened by severe illness or aging. Some anabolic steroids are given as appetite stimulants.
Anorexia — Loss of appetite for food.
Antiemetic — A type of medication given to relieve or prevent nausea and vomiting. Some appetite-enhancing drugs are also used as antiemetics.
Appetite — The natural instinctive desire for food. It should be distinguished from hunger, which is the body’s craving or need for food (either calories or specific nutrients).
Cachexia — A condition of general ill health, malnutrition, undesired weight loss, and physical weakness, often associated with cancer.
Off-label — Referring to the use of a drug for a condition or disorder not listed in the official FDA labeling.
Orexigenic — The medical term for drugs that increase or stimulate the appetite.
Palliative — Referring to drugs or other therapies intended to relieve the symptoms of a disease rather than to cure it.
Undernutrition — A type of malnutrition caused by inadequate food intake or the body’s inability to make use of needed nutrients.