Effects of suvorexant: A Synthesis of Findings from 10 Studies

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Original Abstract of the Article

Main research findings

Suvorexant is a novel drug for the treatment of insomnia, a dual antagonist of orexin receptors OX1R and OX2R. 2 Suvorexant promotes sleep by reducing arousal and wakefulness. 2 Suvorexant was approved for the treatment of insomnia based on three clinical trials that found it to be efficacious and relatively well-tolerated. 2 1 7 A study on healthy young men showed that suvorexant significantly improved sleep parameters, such as sleep latency, wake after sleep onset time, and sleep efficiency. 1 However, higher doses of suvorexant showed some evidence of residual effects the following morning. 1 Another study indicated that combining suvorexant with alcohol had additive negative effects on psychomotor performance, such as reaction time, vigilance, and working memory. 4 It is advised not to consume alcohol with suvorexant. 4 A systematic review and meta-analysis of four randomized trials involving 3076 patients with insomnia revealed that suvorexant significantly improved subjective time to sleep onset, subjective total sleep time, and subjective quality of sleep at 1 and 3 months. 7 The most common adverse effects were somnolence, fatigue, and abnormal dreams. 7

Benefits and Risks

Benefit Summary

Suvorexant is a promising treatment option for insomnia. 2 7 Studies show that it can improve sleep parameters such as sleep latency, wake after sleep onset, and sleep efficiency. 1 7 Furthermore, suvorexant appears to have fewer next-day residual effects compared to other hypnotics. 10

Risk Summary

Suvorexant can cause side effects such as somnolence, headache, and dry mouth. 2 It is contraindicated in patients with narcolepsy and should be used with caution in patients at risk for REM sleep behavior disorder, depression, or delirium. 2 Combining suvorexant with alcohol can have negative psychomotor effects, such as decreased alertness and increased reaction time. 4

Comparison across Studies

Commonalities across Studies

Several studies have demonstrated the effectiveness of suvorexant in improving sleep parameters in patients with insomnia. 1 7 8 Suvorexant appears to have fewer next-day residual effects compared to other hypnotics. 10 9

Differences across Studies

The side effect profile of suvorexant can vary across studies. 2 7 The impact of suvorexant combined with alcohol on psychomotor performance can also vary across studies. 4

Consistency and Discrepancies in Findings

Several studies have consistently demonstrated the efficacy of suvorexant in treating insomnia. 1 7 8 However, the side effect profile and the impact of combining suvorexant with alcohol have shown some discrepancies across studies. 2 4 Further research is necessary to address these discrepancies. 2 4

Considerations for Real-World Application

While suvorexant shows promise for treating insomnia, it is essential to avoid consuming alcohol while taking it. 4 Additionally, individuals with narcolepsy or those at risk for REM sleep behavior disorder, depression, or delirium should use suvorexant with caution or avoid it entirely. 2 4

Limitations of Current Research

Further research is needed to investigate the side effect profile of suvorexant more comprehensively. 2 4 Comparative studies comparing suvorexant with other hypnotics are necessary to determine its advantages and disadvantages. 10

Future Research Directions

Future studies should focus on further investigating the side effect profile of suvorexant, particularly regarding its combination with alcohol. 2 4 Comparative effectiveness trials are also crucial to establish the place of suvorexant within the treatment of insomnia. 7

Conclusion

Suvorexant is a promising new drug for the treatment of insomnia. 2 1 7 8 It has been shown to improve sleep parameters such as sleep onset latency, total sleep time, and sleep quality. 7 8 However, it is important to be aware of the potential side effects, including somnolence, headache, and dry mouth. 2 Suvorexant is contraindicated in patients with narcolepsy, and its use should be avoided or closely monitored in patients at risk for REM sleep behavior disorder, depression, or delirium. 2 It is also important to avoid consuming alcohol with suvorexant. 4 When considering suvorexant, it is essential to weigh the potential benefits and risks. 2 1 7 8

Literature analysis of 10 papers
Positive Content
8
Neutral Content
1
Negative Content
1
Article Type
9
1
1
1
10
1.

Effects of suvorexant, an orexin receptor antagonist, on sleep parameters as measured by polysomnography in healthy men.

Author: SunHong, KennedyWilliam P, WilbrahamDarren, LewisNicole, CalderNicole, LiXiaodong, MaJunshui, YeeKa Lai, ErmlichSusan, ManginEric, LinesChristopher, RosenLaura, ChodakewitzJeffrey, MurphyGail M

Promoted sleep
Residual effects at high doses

Suvorexant, an orexin receptor antagonist, promoted sleep in healthy young men without sleep disorders. While the 10 mg dose was well tolerated, higher doses (50 and 100 mg) were associated with residual effects the next morning.

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

2.

Suvorexant: a novel therapy for the treatment of insomnia.

Author: HowlandRobert H

Improved sleep
Dry mouth
Headache
Somnolence

Suvorexant, a dual orexin receptor antagonist, promotes sleep by reducing arousal. Clinical trials show it is effective for insomnia and well-tolerated, with somnolence, headache, and dry mouth being the most common side effects. It is contraindicated in narcolepsy and should be used cautiously in patients at risk for REM sleep behavior disorder, depression, or delirium.

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.

Language : English

3.

Effects of the orexin receptor antagonist suvorexant on respiration during sleep in healthy subjects.

Author: UemuraNaoto, McCreaJacqueline, SunHong, DonikyanMardik, ZammitGary, LiuRong, LouridasBonnie, MarsilioSabrina, LinesChristopher, TroyerMatthew D, WagnerJohn

insomnia treatment

The study evaluated suvorexant effects on respiration during sleep in healthy adult men and women.

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

4.

Psychomotor effects, pharmacokinetics and safety of the orexin receptor antagonist suvorexant administered in combination with alcohol in healthy subjects.

Author: SunHong, YeeKa Lai, GillSean, LiuWen, LiXiaodong, PanebiancoDeborah, ManginEric, MorrisonDennis, McCreaJacqueline, WagnerJohn A, TroyerMatthew D

Impaired cognition

This study investigated the psychomotor effects of the orexin receptor antagonist suvorexant with and without alcohol.

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

5.

Effects of suvorexant on sleep architecture and power spectral profile in patients with insomnia: analysis of pooled phase 3 data.

Author: SnyderEllen, MaJunshui, SvetnikVladimir, ConnorKathryn M, LinesChristopher, MichelsonDavid, HerringW Joseph

Improved sleep quality
Increased sleep time
Reduced REM latency
None mentioned

Suvorexant increased the time spent in all sleep stages compared with placebo. The largest differences from placebo were observed at Night-1 and generally diminished over time.

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, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Assessment of the Abuse Potential of the Orexin Receptor Antagonist, Suvorexant, Compared With Zolpidem in a Randomized Crossover Study.

Author: SchoedelKerri A, SunHong, SellersEdward M, FaulknorJanice, Levy-CoopermanNaama, LiXiaodong, KennedyWilliam P, ChaJang-Ho, LewisNicole M, LiuWen, BondiskeyPhung, McCreaJacqueline B, PanebiancoDeborah L, TroyerMatthew D, WagnerJohn A

Reduced adverse events
Abuse potential
Drug liking

Suvorexant, a dual orexin receptor antagonist, demonstrated abuse potential, similar to zolpidem. However, suvorexant had a reduced incidence of abuse-related adverse events, suggesting that its overall abuse liability may be lower than zolpidem.

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.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Suvorexant for the treatment of primary insomnia: A systematic review and meta-analysis.

Author: KuriyamaAkira, TabataHiromitsu

Improved sleep onset
Improved sleep quality
Abnormal dreams
Fatigue
Somnolence

This systematic review and meta-analysis assessed the efficacy and safety of suvorexant, a dual orexin receptor agonist, for the treatment of primary insomnia. Suvorexant is approved for the treatment of insomnia in the United States and Japan.

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.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Effects of suvorexant on the Insomnia Severity Index in patients with insomnia: analysis of pooled phase 3 data.

Author: HerringW Joseph, ConnorKathryn M, SnyderEllen, SnavelyDuane B, MorinCharles M, LinesChristopher, MichelsonDavid

Improved sleep
Reduced impact on daytime function

Suvorexant improved sleep quality and reduced the impact of insomnia on daytime function in patients with insomnia, as measured by the Insomnia Severity Index.

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, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Effects of Bedtime Dosing With Suvorexant and Zolpidem on Balance and Psychomotor Performance in Healthy Elderly Participants During the Night and in the Morning.

Author: BlandHubert, LiXiaodong, ManginEric, YeeKa Lai, LinesChristopher, HerringW Joseph, GillespieGillian

Impaired balance
Impaired psychomotor performance

Suvorexant, an orexin receptor antagonist, impaired balance in healthy elderly participants at a supratherapeutic dose (30 mg). In a crossover study, both suvorexant and zolpidem increased body sway at 1.5 hours after administration, but suvorexant showed less impairment than zolpidem. Suvorexant also increased reaction time at 1.5 hours. Further studies are needed to confirm these findings.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
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.

Language : English

10.

Residual effects of low dose of suvorexant, zolpidem, and ramelteon in healthy elderly subjects: A randomized double-blind study.

Author: UemuraSachiko Ito, ImanishiAya, TeruiYoshino, ParkInsung, SatakeMasahiro, HanGoEun, ShioyaTakanobu, KanbayashiTakashi, NishinoSeiji

Sleep quality

This study compares the effects of suvorexant, a new orexin antagonist, zolpidem, ramelteon, and placebo on elderly subjects, evaluating the next-day residual effects of each hypnotic agent on physical and cognitive function.

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

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