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, 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, 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. 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.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. 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 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 α2δ VDCC ligands — gabapentin, pregabalinLYRICA (pregabalin), CV. Full Prescribing Information, Section 5.7 (Weight Gain). Pfizer, Inc. Revised June, 2013. Ghrelin receptor agonists such as anamorelin, GHRP-6, ibutamoren, ipamorelin, and pralmorelin MC4 receptor antagonists Insulin Sugars, such as fructose Alcohol beverages Benzodiazepines, such as diazepam

See also Anorectic (anorexigenic) Anorexia Eating disorder Obesity Organic feeding disorder Polydipsia

References

Further reading

Agents Used as Appetite Stimulants: Drug Class; University of Utah College of Pharmacy, 2014

External links