Out Of The Pipeline

Suvorexant for sleep-onset insomnia or sleep-maintenance insomnia, or both

Author and Disclosure Information

 

References

There are no specified limitations on the duration of suvorexant use. There is no evidence of withdrawal effects when discontinuing the medication. Patients tak­ing suvorexant should be educated about possible next-day effects that might impair driving or other activities that require full mental alertness, especially if they are tak­ing the 20-mg dosage.


Bottom Line
Suvorexant is FDA-approved for treating sleep onset and sleep maintenance insomnia. The drug is a dual orexin-receptor antagonist, which targets persistent CNS hyperarousal. In clinical trials, suvorexant improved the ability to fall asleep and remain asleep in patients with insomnia. It is generally safe and well tolerated. However, these studies evaluated dosages higher than those approved by the FDA.

Related Resources
• Jacobson LH, Callander GE, Hoyer D. Suvorexant for the treatment of insomnia. Expert Rev Clin Pharmacol. 2014; 7(6):711-730.
• Neubauer DN. New and emerging pharmacotherapeutic approaches for insomnia. Int Rev Psychiatry. 2014;26(2): 214-224.


Drug Brand Names
Doxepin • Silenor Suvorexant • Belsomra
Digoxin • Lanoxin Zaleplon • Sonata
Eszopiclone • Lunesta Zolpidem • Ambien,
Ramelteon • Rozerem Edluar, Intermezzo

Disclosure
Dr. Neubauer is a consultant to Ferring Pharmaceuticals and Vanda Pharmaceuticals.

Pages

Recommended Reading

FDA approves novel insomnia drug suvorexant
MDedge Psychiatry
Review finds sparse evidence for sleep/wake drugs in shift workers
MDedge Psychiatry
Poor sleep and mental disorder symptoms common in college students
MDedge Psychiatry
Assess patient’s body clock before treating circadian rhythm sleep disorders
MDedge Psychiatry
Daily cannabis use in teens linked to lower educational attainment, increased suicide risk
MDedge Psychiatry
Long-term benzodiazepine use may contribute to risk of Alzheimer’s
MDedge Psychiatry
Sedative-hypnotics for sleepless geriatric patients
MDedge Psychiatry
FDA panel supports retaining Chantix boxed warning for now
MDedge Psychiatry
VIDEO: Winning health apps link patients, researchers
MDedge Psychiatry
Sexsomnia may gain more awareness after DSM-5 inclusion
MDedge Psychiatry