Effects of solriamfetol: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Findings

Solriamfetol is a wake-promoting agent that has been shown to be effective in treating excessive sleepiness (ES) in individuals with narcolepsy and obstructive sleep apnea (OSA). 24

In clinical trials, solriamfetol demonstrated dose-dependent improvement in wakefulness compared to placebo, with statistically significant improvements in maintenance of wakefulness tests. 24 , 15

Solriamfetol has a unique mechanism of action, inhibiting the reuptake of dopamine and norepinephrine, which may result in lower abuse potential compared to other stimulants. 24

Solriamfetol has been shown to improve on-the-road driving performance in individuals with OSA and ES. 10

In a murine model of narcolepsy, solriamfetol was found to effectively promote wakefulness without inducing psychomotor effects or anxiety-related behaviors, unlike modafinil. 6

A study in a murine model of OSA revealed that solriamfetol enhanced wakefulness and improved both cognitive function and anxiety levels. 4

Benefits and Risks

Benefits Summary

Solriamfetol may be a safe and effective option for treating ES in narcolepsy and OSA patients, with a lower potential for abuse compared to other stimulants. 24 , 15

It has demonstrated improvements in wakefulness, cognitive function, and driving performance in individuals with OSA and ES. 10 , 4

Solriamfetol may have a lower risk of drug interactions and adverse effects compared to other wake-promoting agents. 15

Risks Summary

Common adverse effects of solriamfetol include headache, nausea, decreased appetite, anxiety, dry mouth, and diarrhea. 24 , 15

Further research is needed to fully understand the long-term effects of solriamfetol. 11

Comparison Across Studies

Commonalities

Multiple studies consistently demonstrate that solriamfetol is effective in improving wakefulness and reducing ES in individuals with narcolepsy and OSA. 24 , 15

Common adverse events reported across studies include headache, nausea, decreased appetite, anxiety, dry mouth, and diarrhea. 24 , 15

Differences

Some studies have investigated the differential effects of solriamfetol based on factors such as patient adherence to primary OSA therapy, the presence of cataplexy in narcolepsy patients, and the presence of a history of depression. 23 , 16 , 9

Comparisons with other wake-promoting agents, such as modafinil and armodafinil, have been conducted in some studies, examining efficacy, safety, and specific effects on cognition and anxiety. 14 , 6 , 3

Some studies have focused on the long-term effects of solriamfetol on quality of life and work productivity. 11 , 1

Consistency and Contradictions

The results of multiple studies consistently suggest that solriamfetol is an effective treatment option for ES in individuals with narcolepsy and OSA. 24 , 15

However, there are some inconsistencies in the findings, particularly regarding the potential for individual variations in response, the effects of comorbidities, and the long-term effects of solriamfetol. 23 , 16 , 9 , 11

Practical Implications

Solriamfetol may be a valuable treatment option for individuals with narcolepsy and OSA who experience ES, offering improvements in wakefulness and quality of life. 24 , 15 , 1

However, it is important to remember that individual responses to solriamfetol can vary, and the presence of other medical conditions or medications may influence its effectiveness and safety. 23 , 16 , 9

It is essential to discuss the use of solriamfetol with a qualified healthcare professional to determine if it is the appropriate treatment option based on individual needs and medical history. 24 , 15 , 1

Limitations of Current Research

The existing research on solriamfetol is still limited, and further studies are needed to fully understand its long-term effects, potential interactions with other medications, and its efficacy in specific subpopulations. 11

Future Research Directions

Future research should focus on investigating the long-term safety and effectiveness of solriamfetol, particularly in individuals with specific comorbidities, and exploring its potential for treating other sleep disorders. 11

Head-to-head comparisons with other wake-promoting agents are also needed to better understand the relative benefits and risks of different treatment options. 3

Conclusion

Solriamfetol presents a promising therapeutic option for individuals with narcolepsy and OSA experiencing ES, offering potential improvements in wakefulness, quality of life, and driving performance. However, individual responses may vary, and careful consideration of medical history and potential interactions is crucial. 24 , 15 , 1

Consultation with a healthcare professional is essential to determine if solriamfetol is the appropriate treatment choice based on individual needs and to monitor for any potential side effects. Further research is ongoing to enhance our understanding of solriamfetol's long-term impact and its effectiveness in various subpopulations. 24 , 15 , 1

Literature analysis of 24 papers
Positive Content
24
Neutral Content
0
Negative Content
0
Article Type
4
3
3
8
24
1.

Solriamfetol: A Review in Excessive Daytime Sleepiness Associated with Narcolepsy and Obstructive Sleep Apnoea.

Author: HoySheridan M

Improved wakefulness
Reduced sleepiness

Solriamfetol is an oral selective dopamine and norepinephrine reuptake inhibitor approved for improving wakefulness in adults with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnoea. In clinical trials, it has been shown to improve wakefulness and reduce excessive sleepiness.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Comparative Efficacy and Safety of Wakefulness-Promoting Agents for Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea : A Systematic Review and Network Meta-analysis.

Author: PitreTyler, MahJasmine, RobertsSarah, DesaiKairavi, GuYusing, RyanClodagh, BusseJason W, ZeraatkarDena

Improved MWT
Reduced EDS
Increased discontinuation due to adverse events

Solriamfetol, armodafinil-modafinil, and pitolisant are effective in reducing daytime sleepiness for patients with obstructive sleep apnea (OSA) already on conventional therapy. Solriamfetol appears to be superior to the other two medications, but all three may increase the risk for discontinuation due to adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Solriamfetol enhances wakefulness and improves cognition and anxiety in a murine model of OSA.

Author: BadranMohammad, PuechClementine, BarrowMax B, RunionAlexandra R, GozalDavid

Improved wakefulness

Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and can cause excessive daytime sleepiness (EDS). This abstract discusses the use of modafinil (MOD) and solriamfetol (SOL), potent wake-promoting agents, to improve wakefulness in OSA patients with EDS.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled Trial, VeterinaryRandomized controlled trials involving animals. They evaluate the efficacy and safety of treatment methods.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Solriamfetol improves chronic sleep fragmentation-induced increases in sleep propensity and ameliorates explicit memory in male mice.

Author: PuechClementine, BadranMohammad, BarrowMax B, RunionAlexandra R, GozalDavid

EDS improvement
Anxiety behaviors

Obstructive sleep apnea (OSA) is a sleep disorder that causes pauses in breathing, leading to sleep fragmentation and daytime sleepiness. This study investigated the effects of two wake-promoting agents, solriamfetol (SOL) and modafinil (MOD), in a mouse model of OSA. Both drugs decreased sleepiness, but only SOL improved memory function. MOD, however, increased anxiety behaviors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Solriamfetol Titration & AdministRaTion (START) in Patients With Narcolepsy.

Author: ThorpyMichael J, HymanDanielle, ParksGregory S, ChenAbby, FoleyCatherine, BaldysBeth, ItoDiane, SinghHaramandeep

Treats excessive daytime sleepiness

This study characterized real-world titration strategies for patients with narcolepsy initiating solriamfetol therapy. It analyzed how solriamfetol, a dopamine/norepinephrine reuptake inhibitor, is titrated in patients with narcolepsy and obstructive sleep apnea.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Solriamfetol treatment of excessive daytime sleepiness in participants with narcolepsy or obstructive sleep apnea with a history of depression.

Author: KrystalAndrew D, BencaRuth M, RosenbergRussell, SchweitzerPaula K, MalhotraAtul, BabsonKimberly, LeeLawrence, BujanoverShay, StrohlKingman P

Effective for EDS
Improved sleepiness
Anxiety
Decreased appetite
Headache
Nausea

This study found that solriamfetol, a medication for excessive daytime sleepiness (EDS), is safe and effective for treating EDS in narcolepsy and OSA regardless of a history of depression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Effects of solriamfetol on on-the-road driving performance in participants with excessive daytime sleepiness associated with obstructive sleep apnoea.

Author: VinckenboschFrederick, AsinJerryll, de VriesNicolaas, VonkPatty E, DonjacourClaire E H M, LammersGert Jan, OvereemSebastiaan, JanssenHennie, WangGrace, ChenDan, CarterLawrence P, ZhouKefei, VermeerenAnnemiek, RamaekersJohannes G

Improved driving
Headache
Insomnia
Nausea

Solriamfetol significantly improved on-the-road driving performance in participants with excessive daytime sleepiness associated with obstructive sleep apnea.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Long-term effects of solriamfetol on quality of life and work productivity in participants with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea.

Author: WeaverTerri E, PepinJean-Louis, SchwabRichard, ShapiroColin, HednerJan, AhmedMansoor, Foldvary-SchaeferNancy, StrolloPatrick J, MayerGeert, SarmientoKathleen, BaladiMichelle, BronMorgan, ChandlerPatricia, LeeLawrence, MalhotraAtul

Improved quality of life
Reduced daytime sleepiness

Solriamfetol, a dopamine/norepinephrine reuptake inhibitor, is approved for excessive daytime sleepiness in adults with narcolepsy or obstructive sleep apnea (OSA). In 12-week studies, solriamfetol improved quality of life in patients with narcolepsy or OSA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Drugs for patients with epilepsy and excessive daytime sleepiness.

Author: ZaccaraGaetano, BartoliniEmanuele, TramacereLuciana, LattanziSimona

Epilepsy treatment
Sleepiness reduction
Cardiovascular events
Drug interactions
Psychiatric symptoms

This review discusses the management of excessive daytime sleepiness (EDS) and attentional deficits in patients with epilepsy. The review suggests that lamotrigine, lacosamide, and perhaps eslicarbazepine may be less sedative than other ASMs. The review also discusses the advantages and risks of using psychostimulants in patients with severe EDS or ADHD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Pitolisant, a wake-promoting agent devoid of psychostimulant properties: Preclinical comparison with amphetamine, modafinil, and solriamfetol.

Author: KriefStéphane, Berrebi-BertrandIsabelle, NagmarIsabelle, GiretMartin, BelliardSimon, PerrinDavid, UguenMarilyne, RobertPhilippe, LecomteJeanne-Marie, SchwartzJean-Charles, FinanceOlivier, LigneauXavier

EDS treatment
pitolisant
psychostimulants

Pitolisant, a selective H3 receptor antagonist/inverse agonist, demonstrated different biochemical, neurochemical, and behavioral profiles compared to amphetamine, modafinil, and solriamfetol, making it a differentiated therapeutic option for excessive daytime sleepiness.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Indirect treatment comparison of solriamfetol, modafinil, and armodafinil for excessive daytime sleepiness in obstructive sleep apnea.

Author: RonnebaumSarah, BronMorgan, PatelDipen, MennoDiane, BujanoverShay, KratochvilDavid, LucasEleanor, StepnowskyCarl

Excessive daytime sleepiness treatment

This meta-analysis compared the efficacy and safety of medications for treating excessive daytime sleepiness associated with obstructive sleep apnea. Solriamfetol, modafinil, and armodafinil were evaluated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Solriamfetol for the Management of Excessive Daytime Sleepiness.

Author: CuomoMegan C, SheehanAmy H, JordanJoe K

EDS management
Headache
Nausea

Solriamfetol is an effective option for management of excessive daytime sleepiness in patients with narcolepsy and obstructive sleep apnea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Randomized Controlled Trial of Solriamfetol for Excessive Daytime Sleepiness in OSA: An Analysis of Subgroups Adherent or Nonadherent to OSA Treatment.

Author: SchweitzerPaula K, MayerGeert, RosenbergRussell, MalhotraAtul, ZammitGary K, GotfriedMark, ChandlerPatricia, BaladiMichelle, StrohlKingman P

Improved EDS
Anxiety
Decreased appetite
Diarrhea
Headache
Nasopharyngitis
Nausea

Solriamfetol improved excessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA) patients regardless of their adherence to primary OSA therapy.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

17.

Excessive Daytime Sleepiness in Obstructive Sleep Apnea. Mechanisms and Clinical Management.

Author: LalChitra, WeaverTerri E, BaeCharles J, StrohlKingman P

Improved quality of life
Reduced sleepiness
Cognitive impairment

Excessive daytime sleepiness (EDS) is a common symptom in patients with obstructive sleep apnea (OSA). While CPAP therapy can reduce EDS, a significant proportion of patients continue to experience it. This review discusses the pathophysiology and clinical management of EDS in patients with OSA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Clinically relevant effects of solriamfetol on excessive daytime sleepiness: a posthoc analysis of the magnitude of change in clinical trials in adults with narcolepsy or obstructive sleep apnea.

Author: RosenbergRussell, BaladiMichelle, BronMorgan

Reduced excessive daytime sleepiness
Decreased appetite
Headache
Nausea

Solriamfetol was found to be effective in treating excessive daytime sleepiness in participants with narcolepsy or obstructive sleep apnea (OSA) with a greater percentage of participants achieving normal Epworth Sleepiness Scale (ESS) scores or clinically meaningful improvements on the ESS compared with those receiving placebo.

Clinical StudyResearch involving human participants to assess the safety, efficacy, and effects of an intervention/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Efficacy and safety of solriamfetol for excessive daytime sleepiness in narcolepsy and obstructive sleep apnea: a systematic review and meta-analysis of clinical trials.

Author: SubediRoshan, SinghRajshree, ThakurRahul Kumar, K CBibek, JhaDivyanshu, RayBarun Kumar

EDS treatment

This review assesses the efficacy and safety of solriamfetol, a selective norepinephrine-dopamine reuptake inhibitor, for treating excessive daytime sleepiness (EDS) in patients with narcolepsy or obstructive sleep apnea (OSA). The review concludes that solriamfetol is effective in improving wakefulness and reducing sleepiness in these patients, with a favorable safety profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

New pharmacologic agents for insomnia and hypersomnia.

Author: EarlDavid C, Van TyleKendall M

Hypersomnia treatment
Insomnia treatment

This review summarizes recent developments and changes in the treatment of insomnia and hypersomnia, highlighting new agents with novel mechanisms of action.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Solriamfetol for the Treatment of Excessive Daytime Sleepiness in Participants with Narcolepsy with and without Cataplexy: Subgroup Analysis of Efficacy and Safety Data by Cataplexy Status in a Randomized Controlled Trial.

Author: DauvilliersYves, ShapiroColin, MayerGeert, LammersGert Jan, EmsellemHelene, PlazziGiuseppe, ChenDan, CarterLawrence P, LeeLawrence, BlackJed, ThorpyMichael J

EDS treatment

Solriamfetol, a dopamine/norepinephrine reuptake inhibitor, was effective in treating excessive daytime sleepiness (EDS) in participants with narcolepsy, regardless of cataplexy status. The drug showed robust effects on the Maintenance of Wakefulness Test (MWT), Epworth Sleepiness Scale (ESS), and Patient Global Impression of Change (PGI-C).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Solriamfetol for Excessive Sleepiness in Narcolepsy and Obstructive Sleep Apnea.

Author: PowellJason, PiszczatoskiChris, GarlandScott

ES treatment
Solriamfetol safety

Solriamfetol, a novel wakefulness-promoting agent, has been approved by the FDA for the treatment of excessive sleepiness related to narcolepsy and obstructive sleep apnea. The review summarizes clinical trial data supporting its safety and efficacy, suggesting it may be a valuable option for managing excessive sleepiness.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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