appetite stimulants


Summary: Agents that are used to stimulate appetite. These drugs are frequently used to treat anorexia associated with cancer and AIDS.

Top Publications

  1. Nasr S, Drury D. Appetite stimulants use in cystic fibrosis. Pediatr Pulmonol. 2008;43:209-19 pubmed publisher
    ..b>Appetite stimulants, although efficacious in treating malnutrition in CF, should only be prescribed if decreased food intake ..
  2. Mulligan K, Zackin R, Von Roenn J, Chesney M, Egorin M, Sattler F, et al. Testosterone supplementation of megestrol therapy does not enhance lean tissue accrual in men with human immunodeficiency virus-associated weight loss: a randomized, double-blind, placebo-controlled, multicenter trial. J Clin Endocrinol Metab. 2007;92:563-70 pubmed
    ..Sexual functioning was preserved with MA/TE but worsened in MA/PL. MA produced robust weight gain. Coadministration of testosterone preserved sexual functioning but did not enhance LBM accrual. ..
  3. Chinuck R, Fortnum H, Baldwin D. Appetite stimulants in cystic fibrosis: a systematic review. J Hum Nutr Diet. 2007;20:526-37 pubmed
    The use of appetite stimulants in cystic fibrosis (CF) is controversial because of doubts concerning efficacy and side-effects. The aim of the review was to establish whether appetite stimulants should be recommended in CF...
  4. Topkan E, Yavuz A, Ozyilkan O. Cancer cachexia: pathophysiologic aspects and treatment options. Asian Pac J Cancer Prev. 2007;8:445-51 pubmed
    ..In the present paper, the current preclinical and clinical features considering the pathophysiology and treatment of cancer related cachexia are reviewed. ..
  5. Evans W. Editorial: Megestrol acetate use for weight gain should be carefully considered. J Clin Endocrinol Metab. 2007;92:420-1 pubmed
  6. Monfared A, Heidarzadeh A, Ghaffari M, Akbarpour M. Effect of megestrol acetate on serum albumin level in malnourished dialysis patients. J Ren Nutr. 2009;19:167-71 pubmed publisher
    ..35 +/- 0.21 to 3.02 +/- 0.48 g/dL. The difference between the two groups was significant (P = .002). At a dose of 40 mg twice a day, MA safely increased serum albumin in malnourished dialysis patients. ..
  7. Mantovani G, Maccio A, Madeddu C, Serpe R, Massa E, Dessì M, et al. Randomized phase III clinical trial of five different arms of treatment in 332 patients with cancer cachexia. Oncologist. 2010;15:200-11 pubmed publisher
    ..The most effective treatment in terms of all three primary efficacy endpoints and the secondary endpoints appetite, IL-6, GPS, and ECOG PS score was the combination regimen that included all selected agents. ..
  8. Yeh S, Marandi M, Thode H, Levine D, Parker T, Dixon T, et al. Report of a pilot, double-blind, placebo-controlled study of megestrol acetate in elderly dialysis patients with cachexia. J Ren Nutr. 2010;20:52-62 pubmed publisher
    ..05). In a pilot trial in dialysis patients, MA showed significant benefits in improving weight and ability to exercise. Cytokine changes were correlated with weight gains and increases in fat-free mass. ..
  9. Prelusky D, Rotter B, Thompson B, Trenholm H. Effect of the appetite stimulant cyproheptadine on deoxynivalenol-induced reductions in feed consumption and weight gain in the mouse. J Environ Sci Health B. 1997;32:429-48 pubmed
    ..Both agents were administered concurrently thereafter for a 12-day period. Dosing levels included various combinations of the two compounds, ranging from 0-16 ppm DON and 0-20 ppm CYP. ..

More Information


  1. Fox C, Treadway A, Blaszczyk A, Sleeper R. Megestrol acetate and mirtazapine for the treatment of unplanned weight loss in the elderly. Pharmacotherapy. 2009;29:383-97 pubmed publisher
    ..Therefore, the use of megestrol acetate or mirtazapine for weight loss should be thoroughly evaluated on an individual basis. Pharmacotherapy should be used only after all underlying causes of weight loss are assessed and treated. ..
  2. Hotta M, Ohwada R, Akamizu T, Shibasaki T, Takano K, Kangawa K. Ghrelin increases hunger and food intake in patients with restricting-type anorexia nervosa: a pilot study. Endocr J. 2009;56:1119-28 pubmed
  3. Marsh D, Weingarth D, Novi D, Chen H, Trumbauer M, Chen A, et al. Melanin-concentrating hormone 1 receptor-deficient mice are lean, hyperactive, and hyperphagic and have altered metabolism. Proc Natl Acad Sci U S A. 2002;99:3240-5 pubmed
    ..We conclude that MCH1R is a physiologically relevant MCH receptor in mice that plays a role in energy homeostasis through multiple actions on locomotor activity, metabolism, appetite, and neuroendocrine function. ..
  4. Baldwin C. Nutritional support for malnourished patients with cancer. Curr Opin Support Palliat Care. 2011;5:29-36 pubmed publisher
    ..Studies characterizing the potential for nutritional support in combination with anti-inflammatory agents in defined patient groups are defined to advance the evidence base in this area. ..
  5. Collins N. Protein-energy malnutrition and involuntary weight loss: nutritional and pharmacological strategies to enhance wound healing. Expert Opin Pharmacother. 2003;4:1121-40 pubmed
    ..More research, however, is needed to define optimal nutritional and anabolic therapies for these patients given the associated high morbidity and cost of care. ..
  6. Kalra S, Kalra P. Neuropeptide Y: a physiological orexigen modulated by the feedback action of ghrelin and leptin. Endocrine. 2003;22:49-56 pubmed
    ..Apparently, the hypothalamic NPY network is the primary common pathway intimately involved in genesis of appetite- stimulating impulses. ..
  7. Mollet A, Gilg S, Riediger T, Lutz T. Infusion of the amylin antagonist AC 187 into the area postrema increases food intake in rats. Physiol Behav. 2004;81:149-55 pubmed
    ..Furthermore, we provide evidence for a physiological role of endogenous amylin to reduce food intake. This may also involve an action via the AP. ..
  8. Baird J, Gray N, Fischer S. Effects of neuropeptide Y on feeding microstructure: dissociation of appetitive and consummatory actions. Behav Neurosci. 2006;120:937-51 pubmed
    ..Therefore, NPY also increased appetitive feeding behaviors, but its consummatory effects were limited to caloric solutions. The results are discussed with regard to their potential to explain current discrepancies in the literature. ..
  9. Chambers A, Vemuri V, Peng Y, Wood J, Olszewska T, Pittman Q, et al. A neutral CB1 receptor antagonist reduces weight gain in rat. Am J Physiol Regul Integr Comp Physiol. 2007;293:R2185-93 pubmed
    ..If these compounds display similar properties in humans, they could be developed into a new class of antiobesity agents. ..
  10. Garin M, Burns C, Kaul S, Cappola A. Clinical review: The human experience with ghrelin administration. J Clin Endocrinol Metab. 2013;98:1826-37 pubmed publisher
    ..There is some evidence to suggest that ghrelin has wider ranging therapeutic effects, although these areas require further investigation. ..
  11. Inui A. [Feeding-related disorders in medicine, with special reference to cancer anorexia-cachexia syndrome]. Rinsho Byori. 2006;54:1044-51 pubmed
    ..As weight loss shortens the survival time of cancer patients and decreases their performance status, effective therapy would extend patient survival and improve quality of life. ..
  12. Freet C, Tesche J, Tompers D, Riegel K, Grigson P. Lewis rats are more sensitive than Fischer rats to successive negative contrast, but less sensitive to the anxiolytic and appetite-stimulating effects of chlordiazepoxide. Pharmacol Biochem Behav. 2006;85:378-84 pubmed
    ..Together, the results show that, while both Lewis and Fischer rats demonstrate SNC, the effect is more sustained in the Lewis rats and these rats are insensitive to both the anxiolytic and the appetite-stimulating effects of CDP. ..
  13. Engström B, Ohrvall M, Sundbom M, Lind L, Karlsson F. Meal suppression of circulating ghrelin is normalized in obese individuals following gastric bypass surgery. Int J Obes (Lond). 2007;31:476-80 pubmed
    ..Marked weight reduction after RYGBP at our hospital is followed by a normalization of ghrelin secretion, illustrated by increased fasting levels compared to the preoperative obese state and regain of meal-induced ghrelin suppression. ..
  14. Powers P, Santana C. Available pharmacological treatments for anorexia nervosa. Expert Opin Pharmacother. 2004;5:2287-92 pubmed
    ..Additional novel treatment approaches are urgently needed for this group of severely ill patients who have a high premature mortality rate. ..
  15. Grey J, Terry P, Higgs S. Contrasting effects of different cannabinoid receptor ligands on mouse ingestive behaviour. Behav Pharmacol. 2012;23:551-9 pubmed publisher
  16. Li J, Wakui R, Horie M, Nishimura Y, Nishiyama Y, Ikeno Y, et al. Feeding stimulant in Cinnamomum camphora for the common bluebottle, Graphium sarpedon nipponum (Lepidoptera: Papilionidae). Z Naturforsch C. 2010;65:571-6 pubmed
    ..Bioassay-guided fractionation of the hexane layer resulted in the isolation of a highly active compound, which was identified as a-linolenic acid by nuclear magnetic resonance spectrometry and gas chromatography-mass spectrometry...
  17. Davis A, Bruce A, Mangiaracina C, Schulz T, Hyman P. Moving from tube to oral feeding in medically fragile nonverbal toddlers. J Pediatr Gastroenterol Nutr. 2009;49:233-6 pubmed publisher
    ..We prescribed 6 weeks of megestrol for hunger provocation while withdrawing tube feedings. A chart review after treatment demonstrated 9 subjects were eating exclusively orally and 1 was eating 50% orally. ..
  18. Bruera E, Castro M. Cannabinoids in supportive care: are they necessary?. Support Care Cancer. 2003;11:133-4 pubmed
  19. Melstrom L, Melstrom K, Ding X, Adrian T. Mechanisms of skeletal muscle degradation and its therapy in cancer cachexia. Histol Histopathol. 2007;22:805-14 pubmed publisher
  20. Strasser F. Clinical application of ghrelin. Curr Pharm Des. 2012;18:4800-12 pubmed
  21. Ebner N, Springer J, Kalantar Zadeh K, Lainscak M, Doehner W, Anker S, et al. Mechanism and novel therapeutic approaches to wasting in chronic disease. Maturitas. 2013;75:199-206 pubmed publisher
    ..We discuss therapeutic targets and such potential modulators as appetite stimulants, selective androgen receptor modulators, amino acids and naturally occurring peptide hormones.
  22. Beal J, Olson R, Lefkowitz L, Laubenstein L, Bellman P, Yangco B, et al. Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia. J Pain Symptom Manage. 1997;14:7-14 pubmed
    ..Adverse events were primarily related to known central nervous system effects of dronabinol. These data support long-term, safe use of dronabinol for anorexia associated with weight loss in patients with AIDS. ..
  23. Steinhart C. HIV-associated wasting in the era of HAART: a practice-based approach to diagnosis and treatment. AIDS Read. 2001;11:557-60, 566-9 pubmed
    ..Early treatment of HIV-associated wasting restores body cell mass, improves quality of life, and reduces the frequency of opportunistic infections and hospitalizations. ..
  24. Caton S, Bate L, Hetherington M. Acute effects of an alcoholic drink on food intake: aperitif versus co-ingestion. Physiol Behav. 2007;90:368-75 pubmed
    ..However, lean healthy men adjusted total EI on the days following the laboratory in all conditions. ..
  25. Williamson P, Browning J, MacDonald R. Megestrol acetate increases short-term food intake in zinc-deficient rats. Physiol Behav. 2002;75:323-30 pubmed
    ..In females, serum IGF-I was not lower in zinc-deficient rats, which may have allowed the improved growth response with MA. Hence, MA administration may be a useful tool to increase consumption of a -Zn diet in short-term studies. ..
  26. Quimby J, Lunn K. Mirtazapine as an appetite stimulant and anti-emetic in cats with chronic kidney disease: a masked placebo-controlled crossover clinical trial. Vet J. 2013;197:651-5 pubmed publisher
    ..Median weight loss during placebo administration was 0.07 kg (range 0-0.34 kg). Mirtazapine is an effective appetite stimulant and anti-emetic for cats with CKD and could be a useful adjunct to the nutritional management of these cases. ..
  27. Haney M, Ward A, Comer S, Foltin R, Fischman M. Abstinence symptoms following oral THC administration to humans. Psychopharmacology (Berl). 1999;141:385-94 pubmed
  28. High K. Nutritional strategies to boost immunity and prevent infection in elderly individuals. Clin Infect Dis. 2001;33:1892-900 pubmed
    ..Drug-nutrient interactions are common in elderly individuals, and care providers should be aware of these interactions. Future research should evaluate important clinical end points rather than merely surrogate markers of immunity. ..
  29. Hobbs D, Bunchman T, Weismantel D, Cole M, Ferguson K, Gast T, et al. Megestrol acetate improves weight gain in pediatric patients with chronic kidney disease. J Ren Nutr. 2010;20:408-13 pubmed publisher
    ..MA appears to effectively improve weight gain in pediatric CKD patients with minimal adverse side effects and may therefore serve as a safe, short-term, nutritional strategy. ..
  30. Williams C, Kirkham T. Observational analysis of feeding induced by Delta9-THC and anandamide. Physiol Behav. 2002;76:241-50 pubmed
    ..Our data suggest that exogenously administered cannabinoids promote eating by increasing the incentive value of food and support a role for endocannabinoids in the regulation of the appetitive aspects of feeding motivation. ..
  31. Yeh S, Lovitt S, Schuster M. Usage of megestrol acetate in the treatment of anorexia-cachexia syndrome in the elderly. J Nutr Health Aging. 2009;13:448-54 pubmed
  32. Druce M, Wren A, Park A, Milton J, Patterson M, Frost G, et al. Ghrelin increases food intake in obese as well as lean subjects. Int J Obes (Lond). 2005;29:1130-6 pubmed
    ..Obese people are sensitive to the appetite-stimulating effects of ghrelin and inhibition of circulating ghrelin may be a useful therapeutic target in the treatment of obesity. ..
  33. Choi J, Hahm K. [Ghrelin; influences on Helicobacter pylori-associated gastric diseases]. Korean J Gastroenterol. 2006;48:75-81 pubmed
    ..Conclusively, besides orexigenic and weight gaining actions of gastric hormone, ghrelin, it likely endows the stomach the protective effect from exogenous damages. ..
  34. Liantonio A, Gramegna G, Carbonara G, Sblendorio V, Pierno S, Fraysse B, et al. Growth hormone secretagogues exert differential effects on skeletal muscle calcium homeostasis in male rats depending on the peptidyl/nonpeptidyl structure. Endocrinology. 2013;154:3764-75 pubmed publisher
  35. Van Harken D, Pei J, Wagner J, Pike I. Pharmacokinetic interaction of megestrol acetate with zidovudine in human immunodeficiency virus-infected patients. Antimicrob Agents Chemother. 1997;41:2480-3 pubmed
  36. Dobrila Dintinjana R, Trivanovic D, Zelic M, Radic M, Dintinjana M, Petranovic D, et al. Nutritional support in patients with colorectal cancer during chemotherapy: does it work?. Hepatogastroenterology. 2013;60:475-80 pubmed
    ..4 months (p=0.022). This study demonstrated that concurrent individualized dietary counseling and nutritional support are effective in improving nutritional status thereby lessening chemotherapy-induced morbidity. ..
  37. Chidakel A, Zweig S, Schlosser J, Homel P, Schappert J, Fleckman A. High prevalence of adrenal suppression during acute illness in hospitalized patients receiving megestrol acetate. J Endocrinol Invest. 2006;29:136-40 pubmed
  38. McLaughlin P. Reports of the death of CB1 antagonists have been greatly exaggerated: recent preclinical findings predict improved safety in the treatment of obesity. Behav Pharmacol. 2012;23:537-50 pubmed publisher
    ..It is concluded that, with increasing emphasis on modeling the more troublesome side-effects of CB1 antagonists, safe, efficacious therapeutic targets may emerge. Further rigorous preclinical testing should be carried out. ..
  39. Kojima M, Kangawa K. [Ghrelin: a novel growth-hormone releasing peptide]. Nihon Rinsho. 2001;59:1400-7 pubmed
    ..Moreover, ghrelin induces appetite-stimulating effect and adiposity in rat. These facts indicate that ghrelin is a natural leptin antagonist. ..
  40. Chen C, Tsai C, Lee W, Liaw W, Chiang C, Ho S, et al. Intracerebroventricular O-n-octanoylated ghrelin and its splice variant-induced feeding is blocked by insulin, independent of obestatin or CRF receptor, in satiated rats. Nutrition. 2012;28:812-20 pubmed publisher
  41. Munshi A, Pandey M, Durga T, Pandey K, Bahadur S, Mohanti B. Weight loss during radiotherapy for head and neck malignancies: what factors impact it?. Nutr Cancer. 2003;47:136-40 pubmed
    ..The role of prophylactic Ryle's tube placement or agents such as megestrol acetate in such patients should be further investigated. ..
  42. Higgs S, Williams C, Kirkham T. Cannabinoid influences on palatability: microstructural analysis of sucrose drinking after delta(9)-tetrahydrocannabinol, anandamide, 2-arachidonoyl glycerol and SR141716. Psychopharmacology (Berl). 2003;165:370-7 pubmed
    ..These data are consistent with endocannabinoid involvement in the mediation of food palatability. ..
  43. Olafsson S, Berstad A. Changes in food tolerance and lifestyle after eradication of Helicobacter pylori. Scand J Gastroenterol. 2003;38:268-76 pubmed
    ..Food was better tolerated, but there were no major changes in lifestyle after eradication of H. pylori. Patients therefore do not abuse the privilege of a more tolerant digestion by indulging in a more unhealthy lifestyle. ..
  44. Bell S, Shepherd R. Optimising nutrition in cystic fibrosis. J Cyst Fibros. 2002;1:47-50 pubmed
  45. Tomiska M, Tomísková M, Salajka F, Adam Z, Vorlicek J. Palliative treatment of cancer anorexia with oral suspension of megestrol acetate. Neoplasma. 2003;50:227-33 pubmed
    Megestrol acetate (MA) is a progestational agent, currently known as one of the most effective appetite stimulants in patients suffering from cancer anorexia/cachexia syndrome...
  46. Zukerman S, Ackroff K, Sclafani A. Rapid post-oral stimulation of intake and flavor conditioning by glucose and fat in the mouse. Am J Physiol Regul Integr Comp Physiol. 2011;301:R1635-47 pubmed publisher
    ..The test procedures developed here can be used to investigate the peripheral and central processes involved in stimulation of intake by post-oral nutrients. ..
  47. Tucci S, Rogers E, Korbonits M, Kirkham T. The cannabinoid CB1 receptor antagonist SR141716 blocks the orexigenic effects of intrahypothalamic ghrelin. Br J Pharmacol. 2004;143:520-3 pubmed
  48. Lundholm K, Gunnebo L, Körner U, Iresjö B, Engström C, Hyltander A, et al. Effects by daily long term provision of ghrelin to unselected weight-losing cancer patients: a randomized double-blind study. Cancer. 2010;116:2044-52 pubmed publisher
    ..The current results suggested that daily, long-term provision of ghrelin to weight-losing cancer patients with solid tumors supports host metabolism, improves appetite, and attenuates catabolism. ..
  49. Gullett N, Rossi P, Kucuk O, Johnstone P. Cancer-induced cachexia: a guide for the oncologist. J Soc Integr Oncol. 2009;7:155-69 pubmed
    ..including hypercaloric feeding and nutritional intervention to address starvation, as well as data on appetite stimulants such as corticosteroids and megestrol acetate...
  50. Caton S, Ball M, Ahern A, Hetherington M. Dose-dependent effects of alcohol on appetite and food intake. Physiol Behav. 2004;81:51-8 pubmed
    ..When this occurs, energy intake is not reduced at subsequent meals. Thus, alcohol may contribute to positive energy balance via its additive effects to total energy intake and by short-term appetite stimulation. ..
  51. Kalra P, Dube M, Xu B, Kalra S. Increased receptor sensitivity to neuropeptide Y in the hypothalamus may underlie transient hyperphagia and body weight gain. Regul Pept. 1997;72:121-30 pubmed
  52. Navari R, Brenner M. Treatment of cancer-related anorexia with olanzapine and megestrol acetate: a randomized trial. Support Care Cancer. 2010;18:951-6 pubmed publisher
    ..There were no grade III or IV treatment-related toxicities in patients receiving MA or the combination of MA plus OLN. The combination of MA and OLN appears to be an effective intervention for patients with CRA. ..