Lost weight and appetite change
My DH is on 10 mg Donepezil and Zoloft 50 mg that was just added 2 months ago. He has improved and so much easier for me. Shadowing improved some and anxiety too. He never argues and just goes with the flow. Although I am noticing his appetite has changed and is losing weight. He will not eat unless I put in front of him.He used to snack in between meals, but no longer (wish I didn’t have that problem). His likes/dislikes have changed. Have any of you experienced this weight loss with your loved ones? He has good blood pressure and he thinks it is better for him. We both exercise regularly.
I mentioned to his PCP a month ago and he said sometimes sertraline can cause weight loss. He is on other medications for horrible sinus drainage which is not getting better. The doctor said he could put him on a med to increase appetite, but said he is taking several meds now. I told doctor I will continue to try and get him to eat more, but appetite has decreased and you can’t make someone eat more. Do any of you have any helpful suggestions? He was Diagnosed with MCI a year ago. We do see a Neurologist in February after 10 months wait. Thanks!
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unfortunately the Aricept/donepezil can cause decreased appetite and a lot of other GI side effects too. Gi side effects are the most common reason for discontinuation. Hard to know, if they were started simulaneously it makes it difficult to judge. You could consider decreasing the Aricept to just 5 mg to see if that makes a difference..,..
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My DH has decreased appetite as well. Things that he normally would eat now he doesn't want to eat. I'm trying smaller more frequent meals to get nutrition in him because he has lost some weight. When his doctor had me try to titrate him to 10mg of Donepezil he could not tolerate it and we had to go back down to 5mg. One thing I'm going to try is to get him those nutrition shakes to get some weight back on him.
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Thank you M1. Yes, I may have to consider decreasing his med. He had some GI issues after he started the Zoloft. The pharmacist said sometimes adding more protein to his diet can help, or those issues could go away after he is on the med for a while. Adding more protein seems to help. Have been taking notes, so I can discuss with the Neurologist in a few weeks. Hoping if he cannot continue with Zoloft he can try something else. Otherwise it has been going well with his moods.
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Thanks you annahowie. I am not sure if it is the increase with the Donepezil. The GI issues began after starting the Zoloft.
Yes, I bought some Insure shakes for him. He doesn’t care for it, and will drink one, but then not hungry for the next meal. He was skipping breakfast and sometimes lunch if I am not around. I try to make sure we sit down together for lunch and supper. He is up very early so I have his berries, cereal, and dish ready for him. His proportions are smaller than how he is used to eat. My DH is active and has not been overweight, so he does not need to lose anymore weight. Then he passes on any desserts or snacks…things he used to love. So with that routine he was losing weight.
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Back a couple years ago when my DH wasn’t eating much and lost 15 pounds, ice cream was the key that turned things around. He would eat lots of it. And it seemed to open the door to everything else. I’ve told a few friends who were having the same problem with spouses not eating, and they had good luck with it too.
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My DH is taking same dose of Aricept and Zoloft and has less appetite. I let him he what he wants, when he wants. He eats less at each meal, but if I remind him there is ice cream in the freezer, he will get a bowl, sometimes twice a day. He is eating yogurt and I try to make sure he has a good protein for lunch and dinner. He does not exercise much, like pulling teeth to get him to move. I do also make sure to have plenty of snacks. He will “ snack” on a put together cracker, cheese and meat tray. I keep a small one going for him. That has helped quite a bit, as he doesn’t eat a lot, but it is added.
i am still very much working ( and need to work) so I can’t always be there for suggestions, but I write him notes, which he sometimes follows.
Hope that helps.
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Thank you ImMaggieMae,
I will have to try it. He used to eat ice cream and glass of milk every night, but that all changed when appetite decreased.
We just bought some ice cream bars at the store a few days.
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Thank you Katielu,
I am going to try and reintroduce ice cream during the day. Notes work for us too. He is up at 5:30 am so I sit out a bowl and berries in refrigerator and write him a note. As I was leaving today, I said don’t forget to microwave the pot pie I have for you. I texted an hour later and he had forgotten, but he did eventually eat it. Another text later, I suggest he eat an ice cream and he did.
He will only exercise if I work out with him.
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My DH lost his appetite on Donepezil so the doctor took him off of it. He is on sertaline and is having no problems.
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What Denise said. DH lost so much weight in just 2 weeks that Dr. stopped the Donepezil. It wasn't worth it. This is a man who loves food but had very little weight to lose. It totally suppressed his appetite and the pounds just melted off, alarmingly fast, so it wasn't even an option to continue. FWIW, many people report little to no noticeable benefit to taking Aricept/Donepezil anyway, so... we did not. He regained his weight almost immediately after discontinuing that med.
He is on Seroquel and Sertraline which has managed his delusions, hallucinations, any depression/anxiety and stabilized sleep over time. Progression still continues and we have had a real roller-coaster with Alz. But the most volatile and risky times were brought under control with this med routine. 5 years post diagnosis, just slipped into Stage 7 and I don't think we really lost anything by not being a candidate for Donepezil by the time we realized something was amiss with his cognition. He would not have been able to continue in his career field with this diagnosis regardless, and was past retirement age anyway. With anosognosia setting in very early, it was hard for him to stop going to work, but we got through that period and have just been taking this disease day by day, since then.
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Thank you Denise. We have an appointment with Neurologist in few weeks and I will discuss with him. He has lost almost 20 pounds in the last year. I have trying others suggestions with ice cream, etc. and it has helped and he has gained a few pounds. I don’t want him to lose anymore weight.
Butterfly Wings, thank you for responding. He was shadowing me constantly, and repeating excessively when the doctor increased the Donepezil. The Zoloft was added later for ocd behaviors and anxiety. My DH has improved and in a good place. I am hoping the Neurologist can help with some suggestions with meds. I would be willing to stop the Donepezil. I do not want him to lose anymore weight.
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My brother, whose wife was refusing to eat, kept her favorite cookies out in sight. Tempted her with what she couldn’t resist! Also, Ensure, or a similar supplemental drink in a flavor he would like.
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Thank you. I wish that would work. Our house is stocked with everything my DH used to like. His tastes have changed and no appetite. He doesn’t remember the foods he didn’t like and will eat some now. My DH has been eating Klondike ice cream bar before bedtime with glass of milk now. Getting him to eat 3 meals now as long as I don’t push large portions.
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Butterfly Wings, I am thinking the Sentraline has been more helpful than the Donepezil. My DH has high anxiety and the improvements I see are from the Zoloft that he started in November. I have not seen any delusions, hallucinations in him yet. He is not repeating as much, and the shadowing decreased some, but still likes to be with me. My DH obsession with our dog is a little better, but still a stress on me. He is generally in a good mood, doesn’t argue. But cognition I see is getting worse.
I am Learning that I cannot count on him anymore. He has to be supervised with eating, dressing properly for cold weather, taking his meds, etc. This has been the recent adjustment for me.
The weight loss worries me. I am going to send a note off to the Neurologist.
Thanks, I appreciate your comment. This site has been so helpful to me. It is heartbreaking for all of us…no matter what stage we are going through.
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justbreathe, statistics i have quoted before are that one in twelve patients benefits from donepezil, one in twelve will have a serious side effect, and for ten of twelve it makes no discernible difference. Id have a very low threshold for stopping it. My partner did not tolerate it and also had severe nausea on Namenda.
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My wife has not been on any kind of medication. She has an excellent appetite and will eat anything you give her. She can eat more than I can. In spite of that, she still lost about 40% of her body weight. Your husband's medications may or may not be the reason for his appetite and weight changes. It's hard to tell. This disease changes people in unpredictable ways.
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My DW has mixed dementia (vascular and alzheimers) and has lost about 20 pounds over the past 2 years. No new meds. I think this is part of the natural history of dementia but clearly medications can play a role. It can be hard to sort it all out.
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Thank you for your reply. What I am reading here that you are suggesting discontinuation of Donepezil?
M1 I am sorry for your LO issues with incontinence. I only hope I can be as strong as you in these stages with my DH as time goes on. I understand wanting to protect her.
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JB, I wouldn’t presume to tell you to discontinue it without discussion with his docs, but the objective data about how much it helps are pretty weak. I personally never saw anyone in my practice that I thought it helped, but that is strictly anecdotal.
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How difficult for you! And discouraging. We can only try to do our best. You can’t ask more of yourself than that.
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Thank you all with your feedback. I am waiting to discuss with neurologist. I did not know the statistics rates with taking Donepezil.
It is difficult because while his memory and cognitive skills have declined, there are still some good ways. The weight loss bothers me though. So I am not sure if the medication is helping some or not at all.
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My appetite only increased. I wanted to reduce my waist with the help of this site https://betterme.world/articles/how-to-get-a-smaller-waist/. I succeeded and now I'm glad that I started doing it, but during that my appetite seemed to go crazy, the main thing is to keep control)
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My situation is pretty much the same. DH is on the same medication regimen but lost 18 pounds in a year! His dr did not think it was the meds. I just made a concerted effort to get him to eat more. I started preparing more food at dinner and fixing his plate for him, fixing his breakfast every morning before I left for work, etc. It seems to have worked and he is putting the weight back on. But his food likes and dislikes has certainly changed. He is much pickier than he used to be and foods he used to eat he will not touch now.
I think lack of appetite is part of the disease.
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Belle60 yes, my DH likes and dislikes have changed too. His appetite did eventually come back. I got him started with ice cream after dinner and it worked. He started eating more at dinner time. Eats breakfast now, and ask about lunch if I don’t have anything prepared. He has only gained 2-3 pounds back which surprises me. I think you are right that weight loss may come with the disease.
I do try have healthy meals. He is always hungry. He makes me laugh because he will tell me every night…dinner tastes so good…doesn’t matter what I fix or how much time I put into it.
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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