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Nursing home has recommended an anti depressant that stimulates appetite for my mother who is 95. She has lost a lot of weight in a short period of time. Wondering if this approach has been helpful to others

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Reply to kimbo56kdm
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Cnbkra: Imho, the root cause of the weight loss should be determined before giving any rx or otc medication. You may be able to amend the loss by providing milkshakes or other food stuffs.
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Reply to Llamalover47
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Just to add one more element to the picture of Remeron (generic mirtazapine), a friend in her 70s was given this drug as an antidepressant, and it presently caused cardiac tachyarrhythmia.

Now, it does sound like the majority of commenters here have had a good experience, resulting in improved appetite, better sleep, and less melancholy.

Maybe your mother will enjoy a good experience, too. I would merely suggest two actions before going ahead with the mirtazapine:

1. Download & read the manufacturer's (Merck) official prescribing information at this link

https://www.merck.com/product/usa/pi_circulars/r/remeron/remeron_tablets_pi.pdf

because consumer information is unreasonably abbreviated; and

2. Make sure her doctor does a full blood test (CBC & chemistry), and an EKG to get a clearer view what is going on internally, and whether she will benefit from (or be harmed by) this medication.

Wishing you all the best!
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Reply to ToBeHelpful
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Until my mother had a stroke around Labor Day, appetite was never an issue - weight gain was, thanks to those lovely ice cream bars! After the stroke, she had difficulty swallowing, so she would pick at or sometimes push food away. She did start to lose weight at that point, but already being overweight it wasn't hurting her. She'd eat a little, enough to get by.

The only experience I've had with Mirtazapine was for cats. That pill isn't very big, and I had to try to cut it into eighths! I didn't realize it's primarily more of an antidepressant or antianxiety medication, with a common side effect being an appetite stimulant. It doesn't work for everyone (many medications work for most people, but there are always those of us out here they don't work for - been there, done that!) For the cats, within 15 min of getting that tiny little bit of the pill, they couldn't get enough food!

The primary side effects listed don't seem too bad, might be worth a try to see if her appetite perks up.

Are you able to visit in the NH now? Perhaps going at meal time, you could help and/or encourage her to eat more? If she's mostly bed ridden, her need for food would be reduced, but it shouldn't result in weight loss. Has a doctor checked her over, to rule out anything else? Does she refuse the foods given to her? Would there be anything else that she likes a lot that might entice her to eat more? Would she drink Ensure? There's a Plus version that has 50% more calories, to help weight gain.
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Reply to disgustedtoo
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Megace is an appetite enhancer that I am aware of, but not an antidepressant. There are other medications that achieve the same goal - increasing appetite and enhancing weight gain. Most are successful. Every medication has multiple effects and works on many body systems. Always look up a proposed medication for side effects and contraindications. Ask staff how they will monitor for problems. Always ask prescribing doctor how frequently patients had these side effects.
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Reply to Taarna
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Cetude's answer is wonderful. I think I couldn't add a thing to that. I wish you the best going forward.
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Reply to AlvaDeer
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It made a big difference in my Dad’s appetite. Worth a try, you can watch for side effects - but it worked well for him - at age 93.
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Reply to BeckyT
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I was having the same issue with moms loss of appetite. She is 82 and is diagnosed with dementia and schizophrenia. Her Doctor prescribed mirtazapine 7.5mg. I give it to her at bed time. She wakes up hungry. I noticed the difference in her appetite. Does not cause her to over eat. Check with her doctor to see if this medication would be something that will benefit her situation.
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Reply to MomsGrace
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Drugs seem like a "quick magic fix" but they are also dangerous. Someone 95 years old--bears extreme caution when it comes to drugs.

Risperdal is an antipsychotic used as an appetite stimulant among the elderly, but realize it can also cause *liver damage*, lethargy, and falls. Risperdal, along with many other psych medications, can also cause nausea, vomiting, diarrhea, constipation, and heartburn. Constipation with the elderly means impaction.

Megace, which is an appetite stimulant is dangerous for the elderly as it can cause blood clots, strokes, heart attacks, enlarged heart, enlarged liver, leukopenia, edema, paresthesia, confusion, convulsion, depression, neuropathy.

Anybody who gives marijuana to the elderly is nothing short of elder abuse since that will also cause confusion, dizziness, and other side effects such as an increased likelihood of falls. CBD oil can include sedation, psychomotor slowing, orthostatic hypotension, and lightheadedness. In other words, falls.

There are reasons why she lost weight:
(1) The CNAs do not have time to hand feed an individual patient--they eat slowly and with careful bites. So they simply remove the tray and chart "refused".
(2) She may have an underlying infection....or be on medication such as an antibiotic which will kill appetite.
(3) She may be dehydrated. The elderly lose their sense of thirst so hydration needs CLOSE supervision to make sure they are getting enough fluids.
(4) When was her last bowel movement? She may be impacted.
(4) She may be in the natural process of dying.
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Reply to cetude
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It's probably the one my sister is on. It does the job...almost too well. My sister has terminal cancer and had no appetite, was losing weight. Now she is gaining, and along with the pain meds feels like going shopping sometimes or to a casino, which her daughter has to take off work to do. And she wants full "Sunday dinner" meals every night, a lot of snacking in-between. Then she feels really bad and is in bed for 2-3 days, has to take laxatives. When is enough enough, when is this creating too much burden for the body to deal with? I read that many terminal patients die first of the complications of starvation, but it's a body's natural way of shutting things down, not prolonging discomfort. There is eating, and there is over-eating. I think there has to be a balance. The med is good, but I think I'm going to stop giving her 2 of the pills at night, to only one. She is on a couple of antidepressants too. You just have to watch and weigh. Hope this helps
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Reply to invsbl
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invsbl Apr 23, 2021
Sorry, I just noted the date the question was posted. Probably solved by now, but may help others
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I would be very careful. Look up all the side effects to the rx they want to administer.

Why don't they try giving her things to do and talking with her if they think she is depressed.

Then put yourself in her shoes, wouldn't you be depressed living where she is?

You could also try adding 1 or 2 breakfast drinks a day line Ensure to help with weight gain.

Part of the aging and dying process is the loss of weight.

As my 96 yr old Dad got older, he ate less and he started spitting out his food, thinking he would get choked to swallow it so I just started buying food that was easy to eat.

He stopped eating meat so he gets his protein from eggs, yogurt and milk.

Prayers
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Reply to bevthegreat
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If she's not depressed, why would she take an anti depressant? Can you talk to her doctor about this? Can her diet be adjusted to have more things like ice cream, yogurt, custards, smoothies, ensure, things that are easy to swallow and taste good?
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Reply to NancyIS
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They tried that with my dad. He did not react well to the medicine. Doc said it was unusual but everyone reacts differently. But at the time my dads organs were starting to shut down. So that should’ve clued the doc in. Is the not eating the only thing going on with your loved one or is there other diagnoses?
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Reply to Frazzledaughter
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Given the likely medications involved, this sounds like a reasonably low-risk action to take to try to increase your mother's appetite. I also realize that since your mother is 95, you probably don't want her to be subjected to many medical procedures. However, I would think you would want the most obvious causes for her lack of adequate eating to be checked out before she started on medication to increase her eating.
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Reply to caroli1
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Cnbkra Apr 20, 2021
Thanks and yes, Definitely wanted to rule out other causes before trying this med. My mother has had a sensitivity to psychotropic medications generally used for Alzheimer’s. Luckily shebhas not seemed depressed and sleeps well.
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You know, I truly believe appetite is an individual thing.

My mom was never a ‘big’ eater. Obviously, she ate enough to keep alive but was thin.

The doctor would tell me to serve her more food. I tried. I couldn’t force her to eat more.

Mom said that while I was growing up, I never seemed to have a big appetite.

I never had a huge interest in food even though she was an excellent cook.

I ate smaller portions and never had second helpings.

The doctor would tell her to buy or make me milk shakes to gain weight.

It never worked. I would drink a shake sometimes but never gained an ounce. It must be my metabolism. I can’t gain weight either. I am no longer underweight but I am thin. The doctor tells me not to lose any weight. She wants me to hold steady or gain a few pounds.

I like to cook but I freeze a lot or the food would go to waste. It’s just hubby and I at home.

Now that mom is at end stage Parkinson’s and dying, she can’t eat. She is super thin. I don’t expect or want her to eat now. There’s no point.

Appetite and metabolism are vary with each individual.
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Reply to NeedHelpWithMom
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Cnbkra Apr 20, 2021
Thanks!
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AKA mirtazapine. I don't think it did anything to improve my mom's desire for food but it did help her to sleep through the night and for a long time it made her seem more like herself during the day. I hope it works for you.
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Cnbkra Apr 22, 2021
Thanks!
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If the drug is Remeron, yes, it worked for my mom.

It stopped what seemed like inexorable weight loss and stabilized her weepiness.

Later on, the geriatric psychiatrist added Lexapro (another anti-depressant) to the mix.

Just to note, this did not make mom dopey or zombie-like or drugged. Just calm and happy instead of weepy, fretful and anxious.
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Reply to BarbBrooklyn
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Cnbkra Apr 20, 2021
Thanks- good to know!
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