suvorexant (Belsomra)
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Introduction
FDA-approved August 2014 for insomnia.
Indications
Dosage
- maximum: 20 mg/day*
Tabs: 5, 10, 15, 20 mg
* at 40 mg for patients < 65 years & 30 mg for older patients, suvorexant superior to placebo in improving several sleep measures in 2 studies[3]
* 20 mg for patients < 65 years & 15 mg for older patients superior to placebo in one study[3]
Pharmacokinetics
- elimination 1/2life 8-19 hours
Adverse effects
- next-day drowsiness
- complex behaviors while not being fully awake[2]
- rebound insomnia[3]
- does not produce narcolepsy[3]
- fracture risk similar to Z-drugs
Mechanism of action
- orexin receptor antagonist
- suvorexant acutely decreases tau phosphorylation & amyloid-beta in human CNS[6]
2023 Jul;94(1):27-40
More general terms
References
- ↑ Physician's First Watch, Dec 9, 2013 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Parker I The Big Sleep New Yorker. Dec 9, 2013 http://www.newyorker.com/reporting/2013/12/09/131209fa_fact_parker - ↑ 2.0 2.1 FDA News Release. August 13, 2014 FDA approves new type of sleep drug, Belsomra http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm409950.htm
- ↑ 3.0 3.1 3.2 3.3 3.4 Herring WJ et al. Suvorexant in patients with insomnia: Results from two 3-month randomized controlled clinical trials. Biol Psychiatry 2014 Oct 22 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25526970 <Internet> http://www.biologicalpsychiatryjournal.com/article/S0006-3223%2814%2900762-8/abstract
- ↑ Herring WJ, Ceesay P, Snyder E et al. Polysomnographic assessment of suvorexant in patients with probable Alzheimer's disease dementia and insomnia: A randomized trial. Alzheimers Dement 2020 Jan 15; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/31944580 https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12035
- ↑ Adomi M et al Comparative risk of fracture in community-dwelling older adults initiating suvorexant versus Z-drugs: Results from LIFE study. J Am Geriatr Soc. 2023 Jan;71(1):109-120 ePub: 2022. Oct 2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36184747 https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.18068
- ↑ 6.0 6.1 Lucey BP, Liu H, Toedebusch CD et al Suvorexant Acutely Decreases Tau Phosphorylation and Abeta in the Human CNS. Ann Neurol. 2023 Jul;94(1):27-40 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36897120 PMCID: PMC10330114 (available on 2024-07-01)