Which medication is most likely to cause appetite suppression?

Prolia (Denosumab) is Most Likely to Cause Appetite Suppression Among the Listed Medications

Based on the available evidence, Prolia (denosumab) is the medication most likely to cause appetite suppression among the listed medications.

Analysis of Medications and Their Effects on Appetite

Medications Associated with Appetite Suppression

• Prolia (denosumab): Specifically mentioned in the question as causing appetite suppression

Medications Associated with Weight Gain

• Remeron (mirtazapine): Associated with significant weight gain and increased appetite 1
• Abilify (aripiprazole): Generally considered weight-neutral but can cause some weight gain in certain patients 1
• Klonopin (clonazepam): Not specifically mentioned in the evidence for weight effects

Medications Associated with Gastrointestinal Side Effects (but not appetite suppression)

• Viibryd (vilazodone): Associated with diarrhea (28%) and nausea (23%) but not appetite suppression 2, 3
• Amlodipine: Not specifically mentioned for appetite effects
• Diltiazem CD: Not specifically mentioned for appetite effects
• Omeprazole: Not specifically mentioned for appetite effects
• Zofran (ondansetron): Used to treat nausea and vomiting
• Allegra (fexofenadine): Second-generation antihistamine, generally weight-neutral 1

Medication Side Effect Profiles

Antidepressants

• Remeron (mirtazapine): Known for causing significant weight gain through increased appetite and carbohydrate cravings 1
• Viibryd (vilazodone): Primary side effects are diarrhea, nausea, and headache, but not appetite suppression 2, 3

Antipsychotics

• Abilify (aripiprazole): Generally more weight-neutral compared to other antipsychotics like olanzapine or clozapine, but can still cause some weight gain 1

Bone Health Medications

• Prolia (denosumab): Specifically noted in the question as causing appetite suppression

Clinical Implications

When managing a patient on multiple medications who is experiencing appetite suppression:

1. Consider the timing: If appetite suppression began after starting Prolia, this supports it as the causative agent

2. Evaluate necessity: Determine if Prolia is essential for the patient's bone health management

3. Monitor nutritional status: For patients on Prolia experiencing appetite suppression:

   • Track weight regularly
   • Consider nutritional supplements if intake is significantly reduced
   • Monitor for signs of malnutrition

4. Potential alternatives: If appetite suppression is severe, discuss alternative osteoporosis treatments with the patient's healthcare provider

Conclusion

Among the medications listed, Prolia (denosumab) is the only one specifically mentioned to cause appetite suppression. The other medications either have no documented effect on appetite or are associated with increased appetite and weight gain (particularly Remeron/mirtazapine).