Use of Orexigenic Medications in Geriatric Patients

In the presence of adequate food, weight loss most often is due to cytokine-associated cachexia and anorexia. Assessment of changes in appetite is essential to evaluating older persons with weight loss. When anorexia is identified, a search for reversible causes should be instituted. Intervention should first be aimed at the provision of adequate calories and protein, often in the form of high-density nutritional supplements. Failure to respond to adequate nutrition or supplements should trigger a concern for cachexia. Orexigenic drugs have been reported to improve appetite and produce weight gain. The mechanism is unknown, but it may relate to suppression of proinflammatory cytokines.