Potential Role of Mirtazapine in Underweight Older Adults

Abstract

Changes in body weight can affect the overall health of an older patient and should not be considered a normal part of the aging process. In particular, weight loss can lead to numerous adverse health outcomes affecting daily activities, loss of functional status, and increased mortality. Approximately 15% to 20% of older adults experience unintentional weight loss and require intervention to maintain quality of life. Currently, there are no pharmacologic agents indicated to treat unintentional weight loss in older adults; however, several medications may aid by stimulating appetite and/or promoting weight gain. In recent years, mirtazapine has gained attention not only for its antidepressant effects, but also for its potential benefits in underweight patients. This agent has been found to increase appetite and weight in adults compared with placebo and other antidepressants, but further clinical investigation is necessary to determine the role of mirtazapine in the older underweight population.

Idalopirdine – a small molecule antagonist of 5-HT6 with therapeutic potential against obesity

“…In particular, weight loss can lead to many health complications affecting daily activities, loss of functional status and mortality. Even looking for drugs that increase body weight in these people (Hilas and Avena-Woods 2014 ).…”

Are the therapeutic strategies in anorexia of ageing effective on nutritional status? A systematic review with meta‐analysis

“…It is important to note that following a nutritional support could be difficult for this population as a result of the coexistence of many factors: loss of appetite, inactivity, sensory impairment, early satiation, psychological disorders and mental impairments. Furthermore, AA treatment requires a multidimensional approach, including food manipulation (improvement of flavour, food texture and palatability, increasing dietary variety, and feeding assistance), correction of environmental threat (preventing social isolation and improving conviviality, particularly in nursing home residents, providing adequate individual feeding assistance, changing the mealtime routine, modifying the dining environment, and staff training), reduction of pharmacological risk factors (a certain number of cardiovascular, psychiatric and anti‐rheumatic drugs may reduce appetite) and treatment of underlying medical causes (swallowing disorders, dyspepsia, malabsorption syndromes, neurological causes, endocrine and psychiatric disorders, respiratory diseases and cardiovascular diseases), as recommended in mumerous studies . Special attention should be also given to the nutritional screening tools, which constitute the primary intervention in the treatment of AA.…”

“…Previously, a study by Hilas et al . involving mirtazapine assessed its favourable effects on appetite and weight in adults compared to placebo and other antidepressants. Mirtazapine may have multiple effects in subjects with weight loss because it relieves symptoms associated with depression, it regulates the gastrointestinal motor or sensory functions, and it significantly increases BW (mainly as a result of growth of visceral fat) .…”

Prevalence and Prescription of Antidepressants in Depression with Somatic Comorbidity in Asia

“…Because SC is associated with a higher frequency of treatment resistance in depressed patients,[ 23 ] according to World Federation of Societies of Biological Psychiatry guidelines,[ 27 ] a combination of an SSRI and mirtazapine is an evidence-based choice in depressed patients for whom monotherapy has failed. And it has special advantages over SSRIs in the treatment of certain symptoms, such as disturbed sleep, poor appetite,[ 28 29 30 ] and sexual dysfunction. [ 31 32 ] Therefore, higher rate of patients in SC group used mirtazapine.…”