![]() ![]() A major systematic review and network meta-analysis of insomnia medications published in 2022 found that suvorexant had an effect size ( standardized mean difference (SMD)) against placebo for treatment of insomnia at 4 weeks of 0.31 (95% CI 0.01 to 0.62). Network meta-analyses have assessed the sleep-promoting effects of suvorexant and have compared them to those of other orexin receptor antagonists like lemborexant and daridorexant as well as to other sleep aids including benzodiazepines, Z-drugs, antihistamines, sedative antidepressants (e.g., trazodone, doxepin, amitriptyline, mirtazapine), and melatonin receptor agonists. The effectiveness of approved doses of suvorexant (≤20 mg) in the treatment of insomnia is said to be modest. A 2017 systematic review and meta-analysis of randomized controlled trials of suvorexant for insomnia likewise found that the medication improved subjective sleep onset, subjective total sleep time, and subjective sleep quality when assessed at one to three months of treatment. At a dose of 15 to 20 mg and in terms of treatment– placebo difference, it reduces time to sleep onset by up to 10 minutes, reduces time awake after sleep onset by about 15 to 30 minutes, and increases total sleep time by about 10 to 20 minutes. Suvorexant is used for the treatment of insomnia, characterized by difficulties with sleep onset and/or sleep maintenance, in adults. Besides suvorexant, other orexin receptor antagonists like lemborexant and daridorexant have also been introduced. ![]() Suvorexant is not available in generic formulations. In other places, such as Australia, suvorexant is a prescription-only medicine and is not a controlled drug. The medication is a schedule IV controlled substance in the United States and may have a modest potential for misuse. Ĭlinical development of suvorexant began in 2006 and it was introduced for medical use in 2014. ![]() Unlike benzodiazepines and Z-drugs, suvorexant does not interact with GABA receptors, instead having a distinct mechanism of action. The medication has an intermediate elimination half-life of 12 hours and a time to peak of about 2 to 3 hours. It acts as a selective dual antagonist of the orexin OX 1 and OX 2 receptors. Suvorexant is a dual orexin receptor antagonist (DORA). Tolerance, dependence, withdrawal, and rebound effects do not appear to occur significantly with the medication. Rarely, sleep paralysis, sleep-related hallucinations, complex sleep behaviors like sleepwalking, and suicidal ideation may occur. Side effects of suvorexant include somnolence, daytime sleepiness and sedation, headache, dizziness, abnormal dreams, dry mouth, and impaired next-day driving ability. Its effectiveness is modest, and is similar to that of other orexin antagonists, but is lower than that of benzodiazepines and Z-drugs. Suvorexant helps with falling asleep faster, sleeping longer, being awake less in the middle of the night, and having better quality of sleep. ![]() It is indicated specifically for the treatment of insomnia characterized by difficulties with sleep onset and/or maintenance in adults. Suvorexant, sold under the brand name Belsomra, is an orexin antagonist medication which is used in the treatment of insomnia. ![]()
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