Appetite Stimulant (Orexigenic)

An appetite stimulant, also called an orexigenic, is a medication that helps increase hunger. Healthcare providers may recommend it if you have loss of appetite due to a health condition like cancer or a long-term illness. They may prescribe an appetite stimulant if you’re not eating enough, losing weight without trying or having trouble getting the nutrition your body needs.

Appetite stimulant medications work in different ways. Some affect brain chemicals that control hunger. Others help reduce nausea or improve mood, which may make eating easier. Providers often prescribe these medications along with other nutrition support, like meal planning or nutritional drinks. You may also need treatment for the underlying cause of your weight loss.

Healthcare providers may use appetite stimulants to help manage:

• Cancer-related weight loss or appetite loss
• HIV/AIDS-related weight loss
• Malnutrition
• Loss of appetite as you age
• Long-term illnesses that make eating difficult
• Depression or other conditions that affect appetite

Appetite stimulants are commonly used in hospitals, cancer care centers and long-term care settings. But research on how well they work is limited. In many cases, they may improve appetite more than they improve weight gain.

Benefits of appetite stimulants may include:

• Increased appetite
• Eating more food
• Better nutrition
• Improved energy or quality of life

Like all medications, orexigenics can cause side effects. Possible risks depend on the medicine. Side effects of appetite stimulants may include:

• Sleepiness or dizziness
• Dry mouth
• Nausea
• Swelling
• Blood clots
• Changes in mood or thinking

Your provider will talk with you about the possible benefits and risks before starting treatment.

What happens during this treatment?

Appetite stimulants usually come as pills or liquids that you take by mouth. You may take some medicines once a day. Others may be taken more often.

Before prescribing an appetite stimulant, your healthcare provider will try to find the cause of your appetite loss. You may need blood tests, imaging tests or a review of your current medications and health conditions.

Your provider may also recommend:

• Nutrition counseling
• Small, frequent meals
• High-calorie or high-protein drinks
• Treatment for nausea, pain or depression

Several prescription medications may act as appetite stimulants:

• Megestrol (Megace^®) is a progestin hormone that decreases the levels of estrogen and other hormones in your body. It may help increase hunger and weight gain.
• Dronabinol (Marinol^® or Syndros^®) is a type of medication called a cannabinoid. It may improve appetite and reduce nausea in people with cancer-related weight loss.
• Mirtazapine (Remeron^®) is an antidepressant that increases the amount of certain chemicals in your brain. Providers sometimes use it off-label to stimulate appetite.
• Cyproheptadine (Periactin™) is a prescription antihistamine. It works by blocking a substance in your body called histamine. Providers often use it to boost hunger signals.
• Corticosteroids (glucocorticoids), like dexamethasone and prednisone, treat a wide range of health conditions. They may also increase appetite.

Your provider will track your weight, appetite and side effects during treatment. They may change your dose or switch medications if needed.

How long will I need this treatment?

How long you need an appetite stimulant depends on why you’re taking it and how well it works for you. Some people take these medications for only a short time during an illness or treatment. Others may need them longer.

How successful is this treatment?

Appetite stimulant medications can help some people eat more or feel hungrier. But results vary. They tend to work best when providers treat the underlying cause of appetite loss at the same time.

How long will it take for my appetite to increase?

Some people notice changes in appetite within a few days. Others may need several weeks before they notice a difference. Your healthcare provider will monitor how you respond to treatment and decide whether the medication is helping.

Is there anything I can do to make this treatment easier on me?

You may feel better during treatment if you:

• Eat small meals more often throughout the day.
• Choose foods high in calories and protein.
• Drink nutrition shakes or smoothies if solid foods are hard to eat.
• Stay hydrated.
• Take your medication exactly as prescribed.
• Tell your provider about side effects.

It may also help to eat with family or friends, keep easy-to-eat snacks nearby and stay as active as your health allows.

When should I call my healthcare provider?

Call your provider if you:

• Continue losing weight
• Can’t eat or drink for more than a day
• Have severe nausea or vomiting
• Feel extremely sleepy or confused
• Notice swelling in your legs
• Have chest pain or trouble breathing
• Feel dizzy or faint

These symptoms may mean your provider needs to make a change to your medication. Or you may need treatment for another condition.

Are appetite stimulants safe for seniors?

They can be, but people ages 65 and up may have a higher risk of side effects like dizziness, confusion or falls. Healthcare providers carefully weigh the benefits and risks before prescribing these medications.

Can children take appetite stimulants?

Children can take appetite stimulants, but only under close medical supervision. Before recommending them, your child’s provider will closely consider the possible side effects and the reason for appetite loss.