Megestrol Acetate and Mirtazapine for the Treatment of Unplanned Weight Loss in the Elderly

@article{Fox2009MegestrolAA,
  title={Megestrol Acetate and Mirtazapine for the Treatment of Unplanned Weight Loss in the Elderly},
  author={Caroloine Fox and Angela K Treadway and Amie T Blaszczyk and Rebecca B. Sleeper},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
  year={2009},
  volume={29}
}
A rising concern among clinicians is treatment of unplanned weight loss in the elderly, especially given the predicted growth of this population over the next few decades. [...] Key Method In a comprehensive search of the MEDLINE and International Pharmaceutical Abstracts databases, we identified all published reports on the use of megestrol acetate or mirtazapine for the treatment of weight loss and on any adverse events associated with these drugs.Expand
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The focus of this article has been limited to reviewing the evidence for current orexigenic agents that are used to treat elderly individuals who are experiencing IWL, and maintaining a healthy weight is an essential element of well-being and decreased morbidity and mortality.
Appetite Stimulants in Long Term Care: A Literature Review
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Current research related to the use of appetite stimulants in long term care, including mirtazepine, oxandrolone, dronabinol, and megesterol acetate is identified, with mixed results.
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Physiatrists are well positioned to have a positive impact on rational prescribing and polypharmacy given their emphasis on function, familiarity with non-medication treatment modalities, and an embrace of a biopsychosocial orientation.
Older Adults With Unintended Weight Loss: The Role of Appetite Stimulants.
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Understanding the dosage, side effects, and proper usage of appetite stimulants, such megestrol acetate, mirtazapine, and dronabinol, is crucial in order to provide safe and effective patient care.
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TLDR
Treatment focuses on the underlying cause, and nutritional supplements and flavor enhancers, and dietary modification that takes into account patient preferences and chewing or swallowing disabilities may be considered.
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Over-the-counter antihistamines may have a role for short-term insomnia treatment in younger adults, but tolerance develops rapidly, and mirtazapine should not be used solely for the treatment of insomnia.
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Appetite loss in older people, the ‘Anorexia of Aging’ (AA), is common, associated with under-nutrition, sarcopenia, and frailty and yet receives little attention, so standardized assessment is important for future research.
Histamine-1 receptor antagonism for treatment of insomnia.
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Over-the-counter antihistamines may have a role for short-term insomnia treatment in younger adults, but tolerance develops rapidly, and mirtazapine should not be used solely for the treatment of insomnia.
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