Appetite stimulant
An orexigenic, or appetite stimulant, is a drug, hormone, or compound that increases appetite and may induce hyperphagia. This can be a medication or a naturally occurring neuropeptide hormone, such as ghrelin, orexin or neuropeptide Y,[1][2] which increases hunger and therefore enhances food consumption. Usually appetite enhancement is considered an undesirable side effect of certain drugs as it leads to unwanted weight gain,[3][4][5] but sometimes it can be beneficial and a drug may be prescribed solely for this purpose, especially when the patient is suffering from severe appetite loss or muscle wasting due to cystic fibrosis, anorexia, old age, cancer or AIDS.[6][7][8][9][10] There are several widely used drugs which can cause a boost in appetite, including tricyclic antidepressants (TCAs), tetracyclic antidepressants, natural or synthetic cannabinoids, first-generation antihistamines, most antipsychotics and many steroid hormones. In the United States, no hormone or drug has currently been approved by the FDA specifically as an orexigenic, with the exception of Dronabinol, which received approval for HIV/AIDS-induced anorexia only.
List of Orexigenics
- 5-HT2C receptor antagonists/inverse agonists — mirtazapine, olanzapine, quetiapine, amitriptyline, cyproheptadine, lurasidone
- H1 receptor antagonists/inverse agonists — mirtazapine, olanzapine, quetiapine, amitriptyline, cyproheptadine, pizotifen
- Dopamine antagonists — haloperidol, chlorpromazine, olanzapine, risperidone, quetiapine
- Adrenergic antagonists:
- β blockers — propranolol, etc.
- Paradoxically, β-adrenergic agonists are also listed.[11]
Not ephedra/clenbuterol (which is an appetite suppressant), but salbutamol, flerobuterol, Zilpaterol, and related drugs.
- α2 adrenergic antagonists — mirtazapine, mianserin
- Mixed α1/β blockers — carvedilol
- α2 Adrenergic agonists — clonidine
- CB1 receptor agonists (cannabinoids — THC/dronabinol (a component of Cannabis), nabilone
- Corticosteroids — dexamethasone, prednisone, hydrocortisone
- Certain pregnene steroids — megestrol acetate, medroxyprogesterone acetate
- Anabolic steroids — oxandrolone, boldenone undecylenate, testosterone
- Other steroids such as Prednisolone
- Sulfonylurea antidiabetic drugs such as glibenclamide, chlorpropamide and tolbutamide
- Mood stabilizers such as lithium
- Some anti-epileptic drugs such as valproate, carbamazepine and gabapentin[12]
- α2δ VDCC ligands — gabapentin, pregabalin[13]
- Ghrelin receptor agonists such as anamorelin, GHRP-6, ibutamoren, ipamorelin, and pralmorelin
- MC4 receptor antagonists
- Insulin
- Sugars, such as fructose[14]
- Alcohol beverages[15]
- Benzodiazepines, such as diazepam[16]
See also
- Anorectic (anorexigenic)
- Anorexia
- Eating disorder
- Obesity
- Organic feeding disorder
- Polydipsia
References
- Diepvens K, Häberer D, Westerterp-Plantenga M (Mar 2008). "Different proteins and biopeptides differently affect satiety and anorexigenic/orexigenic hormones in healthy humans". Int J Obes (Lond). 32 (3): 510–8. doi:10.1038/sj.ijo.0803758. PMID 18345020.
- Akimoto S, Miyasaka K (July 2010). "Age-associated changes of hunger-regulating peptides". Geriatrics & Gerontology International. 10 Suppl 1: S107–19. doi:10.1111/j.1447-0594.2010.00587.x. PMID 20590826. S2CID 33227343.
- Purnell JQ, Weyer C (2003). "Weight effect of current and experimental drugs for diabetes mellitus: from promotion to alleviation of obesity". Treatments in Endocrinology. 2 (1): 33–47. doi:10.2165/00024677-200302010-00004. PMID 15871553. S2CID 8088326.
- Hermansen K, Mortensen LS (2007). "Bodyweight changes associated with antihyperglycaemic agents in type 2 diabetes mellitus". Drug Safety. 30 (12): 1127–42. doi:10.2165/00002018-200730120-00005. PMID 18035865. S2CID 19877584.
- Maayan L, Correll CU (July 2010). "Management of antipsychotic-related weight gain". Expert Review of Neurotherapeutics. 10 (7): 1175–200. doi:10.1586/ern.10.85. PMC 3501406. PMID 20586697.
- Strasser F, Bruera ED (June 2002). "Update on anorexia and cachexia". Hematology/Oncology Clinics of North America. 16 (3): 589–617. doi:10.1016/s0889-8588(02)00011-4. PMID 12170570.
- Nasr SZ, Drury D (March 2008). "use in cystic fibrosis" (PDF). Pediatric Pulmonology. 43 (3): 209–19. doi:10.1002/ppul.20766. hdl:2027.42/57930. PMID 18219690. S2CID 43667706.
- Morley JE (2007). "Weight loss in older persons: new therapeutic approaches". Current Pharmaceutical Design. 13 (35): 3637–47. doi:10.2174/138161207782794149. PMID 18220800.
- Fox CB, Treadway AK, Blaszczyk AT, Sleeper RB (April 2009). "Megestrol acetate and mirtazapine for the treatment of unplanned weight loss in the elderly". Pharmacotherapy. 29 (4): 383–97. doi:10.1592/phco.29.4.383. PMID 19323618. S2CID 6695434.
- Holmes S (July 2009). "A difficult clinical problem: diagnosis, impact and clinical management of cachexia in palliative care". International Journal of Palliative Nursing. 15 (7): 320, 322–6. doi:10.12968/ijpn.2009.15.7.43421. PMID 19648846.
- Lang F, Perrier E, Pellet J. [Noradrenergic hypothesis in anorexia nervosa: prospective study using beta-stimulant therapy]. Ann Med Psychol (Paris). 1983;141(8):918-25.
- Ness-Abramof R, Apovian CM (Aug 2005). "Drug-induced weight gain". Drugs of Today. 41 (8): 547–55. doi:10.1358/dot.2005.41.8.893630. PMID 16234878. S2CID 34960274.
- LYRICA (pregabalin), CV. Full Prescribing Information, Section 5.7 (Weight Gain). Pfizer, Inc. Revised June, 2013.
- "Fructose Metabolism: Relation to Food Intake & Metabolic Dysfunction". themedicalbiochemistrypage.org. Retrieved 14 April 2018.
- Caton SJ, Nolan LJ, Hetherington MM (2015). "Alcohol, Appetite and Loss of Restraint". Curr Obes Rep. 4 (1): 99–105. doi:10.1007/s13679-014-0130-y. PMID 26627094. S2CID 36018101.
- Cooper, S. J. (2005). "Palatability-dependent appetite and benzodiazepines: new directions from the pharmacology of GABA(A) receptor subtypes". Appetite. 44 (2): 133–150. doi:10.1016/j.appet.2005.01.003. PMID 15808888. S2CID 1394424. Retrieved 14 April 2018.
