Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexant
Jessica L Norman, Sarah L Anderson Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA Abstract: Insomnia, a highly prevalent disorder, can be detrimental to patients’ overall health and worsen existing co...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-07-01
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| Series: | Nature and Science of Sleep |
| Subjects: | |
| Online Access: | https://www.dovepress.com/novel-class-of-medications-orexin-receptor-antagonists-in-the-treatmen-peer-reviewed-article-NSS |
| _version_ | 1818743766422388736 |
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| author | Norman JL Anderson SL |
| author_facet | Norman JL Anderson SL |
| author_sort | Norman JL |
| collection | DOAJ |
| description | Jessica L Norman, Sarah L Anderson Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA Abstract: Insomnia, a highly prevalent disorder, can be detrimental to patients’ overall health and worsen existing comorbidities. Patients may have acute episodes of insomnia related to a traumatic event, but more commonly insomnia occurs chronically. While proper sleep hygiene and behavioral therapy play important roles in the nonpharmacologic management of short-term and chronic insomnia, medications may also be required. Historically, insomnia has been treated with agents such as benzodiazepines, nonbenzodiazepine receptor agonists, and melatonin agonists. Dual orexin receptor antagonists represent a new class of medications for the treatment of insomnia, which block the binding of wakefulness-promoting neuropeptides orexin A and orexin B to their respective receptor sites. Suvorexant (Belsomra) is the first dual orexin receptor antagonist to be approved in the US and Japan and has demonstrated efficacy in decreasing time to sleep onset and increasing total sleep time. Its unique mechanism of action, data to support efficacy and safety over 12 months of use, and relative lack of withdrawal effects when discontinued may represent an alternative for patients with chronic insomnia who cannot tolerate or do not receive benefit from more traditional sleep agents. Suvorexant is effective and well tolerated, but precautions exist for certain patient populations, including females, obese patients, and those with respiratory disease. Suvorexant has only been studied vs placebo, and hence it is unknown how it directly compares with other medications approved by the US Food and Drug Administration for insomnia. Suvorexant is not likely to replace benzodiazepines or nonbenzodiazepine receptor antagonists as a first-line sleep agent but does represent a novel option for the treatment of patients with chronic insomnia. Keywords: insomnia, orexin antagonist, suvorexant |
| first_indexed | 2024-12-18T02:33:33Z |
| format | Article |
| id | doaj.art-f5ea8c4db0d84c1db25513681410bbe6 |
| institution | Directory Open Access Journal |
| issn | 1179-1608 |
| language | English |
| last_indexed | 2024-12-18T02:33:33Z |
| publishDate | 2016-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Nature and Science of Sleep |
| spelling | doaj.art-f5ea8c4db0d84c1db25513681410bbe62022-12-21T21:23:50ZengDove Medical PressNature and Science of Sleep1179-16082016-07-012016Issue 123924727914Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexantNorman JLAnderson SLJessica L Norman, Sarah L Anderson Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA Abstract: Insomnia, a highly prevalent disorder, can be detrimental to patients’ overall health and worsen existing comorbidities. Patients may have acute episodes of insomnia related to a traumatic event, but more commonly insomnia occurs chronically. While proper sleep hygiene and behavioral therapy play important roles in the nonpharmacologic management of short-term and chronic insomnia, medications may also be required. Historically, insomnia has been treated with agents such as benzodiazepines, nonbenzodiazepine receptor agonists, and melatonin agonists. Dual orexin receptor antagonists represent a new class of medications for the treatment of insomnia, which block the binding of wakefulness-promoting neuropeptides orexin A and orexin B to their respective receptor sites. Suvorexant (Belsomra) is the first dual orexin receptor antagonist to be approved in the US and Japan and has demonstrated efficacy in decreasing time to sleep onset and increasing total sleep time. Its unique mechanism of action, data to support efficacy and safety over 12 months of use, and relative lack of withdrawal effects when discontinued may represent an alternative for patients with chronic insomnia who cannot tolerate or do not receive benefit from more traditional sleep agents. Suvorexant is effective and well tolerated, but precautions exist for certain patient populations, including females, obese patients, and those with respiratory disease. Suvorexant has only been studied vs placebo, and hence it is unknown how it directly compares with other medications approved by the US Food and Drug Administration for insomnia. Suvorexant is not likely to replace benzodiazepines or nonbenzodiazepine receptor antagonists as a first-line sleep agent but does represent a novel option for the treatment of patients with chronic insomnia. Keywords: insomnia, orexin antagonist, suvorexanthttps://www.dovepress.com/novel-class-of-medications-orexin-receptor-antagonists-in-the-treatmen-peer-reviewed-article-NSSinsomniaorexin antagonistsuvorexant |
| spellingShingle | Norman JL Anderson SL Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexant Nature and Science of Sleep insomnia orexin antagonist suvorexant |
| title | Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexant |
| title_full | Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexant |
| title_fullStr | Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexant |
| title_full_unstemmed | Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexant |
| title_short | Novel class of medications, orexin receptor antagonists, in the treatment of insomnia – critical appraisal of suvorexant |
| title_sort | novel class of medications orexin receptor antagonists in the treatment of insomnia ndash critical appraisal of suvorexant |
| topic | insomnia orexin antagonist suvorexant |
| url | https://www.dovepress.com/novel-class-of-medications-orexin-receptor-antagonists-in-the-treatmen-peer-reviewed-article-NSS |
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