According to the National Health and Nutrition Examination Survey III, 35% to 45% of adults 60 years of age or older had zinc intakes below the estimated average requirement of 6.8 mg/day for elderly females and 9.4 mg/day for elderly males. Zinc deficiency may lead to loss of appetite, impaired immune function, weight loss, delayed healing of wounds, eye and skin lesions, and smell and taste disturbances. Older adults are especially affected by changes in taste sensations because of age-related gustatory dysfunction, use of multiple medications, increased frailty, and zinc deficiency. This article reviews the finding of clinical studies investigating the use of zinc supplementation for improvement with taste disturbances in older adults.

Mirtazapine is an antidepressant approved for the treatment of major depressive disorder. It has been reported to also stimulate appetite and/or increase body weight, which may be beneficial in certain patient populations such as the elderly. To evaluate the use of mirtazapine and other antidepressants in underweight older adults, a retrospective chart review of patients (60 years of age or older and with a body mass index < 22 kg/m2) who were prescribed an antidepressant during hospitalization was conducted over a six-month period at a large university teaching hospital. Results demonstrated that underweight older patients were more likely to receive mirtazapine than any other antidepressant, prompting a systematic literature review to assess its potential role in appetite stimulation and weight gain. In addition, educational inservice training for health care professionals within the institution was provided to discuss the management of weight loss and appetite suppression in the elderly as well as the potential benefits and risks of antidepressant therapy in older adults.

SJS was associated with lamotrigine use, despite appropriate dosing and dosage adjustment.

While no randomized, placebo-controlled studies have assessed the efficacy and long-term safety outcomes of rifaximin in the treatment of HE, rifaximin has demonstrated better efficacy and safety profiles compared with lactulose and neomycin. Future studies should assess HE outcomes with more consistent indexes and measurements and should compare the efficacy and safety of rifaximin with those of metronidazole.