Side Effects of suvorexant: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Main Research Findings

Suvorexant is a novel orexin receptor antagonist that has shown promise in treating insomnia, specifically difficulties falling asleep and/or staying asleep. 23 , 21 , 15 It works by blocking the orexin system, which is involved in regulating wakefulness and sleep, thereby promoting sleep. 23 , 5 Studies have demonstrated that suvorexant, compared to traditional benzodiazepine-based sleeping pills, exhibits fewer next-day sleepiness and cognitive impairment effects, making it a relatively safe option. 3 , 15 However, some patients may experience side effects.

Reasons for Side Effects

Suvorexant promotes sleep by targeting orexin receptors. Orexin also plays a role in other functions like alertness, appetite, and energy metabolism, which means suvorexant could potentially impact these areas as well. Consequently, side effects like drowsiness, appetite changes, and fatigue may occur with suvorexant use.

Common Side Effects

Drowsiness

Drowsiness is a common side effect of suvorexant. 23 , 15 It is more likely to occur when starting the medication or taking higher doses. If you experience severe drowsiness, you may need to adjust your dose or timing.

Headache

Headaches are another potential side effect of suvorexant. 23 These are usually mild and tend to subside with continued use.

Dry Mouth

Suvorexant can cause dry mouth. 23 Staying hydrated by drinking enough fluids can often help alleviate this side effect.

Abnormal Dreams

Some individuals taking suvorexant have reported experiencing abnormal dreams. 20 This side effect may be more common at higher doses.

Sleep Paralysis

Sleep paralysis, a condition where you are unable to move your body upon waking or just before falling asleep, has been reported in some cases of suvorexant use. 20 This side effect is relatively uncommon.

Suicidal Thoughts

Although rare, suicidal thoughts have been associated with suvorexant use. 20 If you experience these thoughts, seek medical attention immediately.

Narcolepsy

Suvorexant is contraindicated for patients with narcolepsy. 23 Narcolepsy is a condition marked by excessive daytime sleepiness. Taking suvorexant could potentially worsen narcolepsy symptoms.

Managing Side Effects

Drowsiness

If you experience severe drowsiness, consider reducing the dose or adjusting the timing of your medication. Avoid driving or operating dangerous machinery.

Headache

Consult your doctor if you experience persistent headaches. You may need a pain reliever.

Dry Mouth

Drink plenty of fluids to address dry mouth. Chewing gum or sucking on candy can also be helpful.

Abnormal Dreams, Sleep Paralysis, Suicidal Thoughts

If you are concerned about these side effects, reach out to your doctor for guidance. You may need to discontinue the medication.

Narcolepsy

Individuals with narcolepsy should avoid taking suvorexant.

Research Comparisons

Common Findings Across Studies

Numerous studies have demonstrated the effectiveness of suvorexant in treating insomnia, particularly difficulties with sleep onset and/or maintenance. 23 , 21 , 15 Furthermore, suvorexant has been shown to have fewer next-day sleepiness and cognitive impairment effects than traditional benzodiazepine-based sleeping pills, suggesting a relatively safe profile. 3 , 15

Discrepancies Across Studies

The frequency and types of side effects reported with suvorexant can vary between studies. Some research has reported side effects like abnormal dreams, sleep paralysis, and suicidal thoughts. 20 However, it's important to note that these side effects are exceptionally rare. Suvorexant is contraindicated in patients with narcolepsy. 23

Practical Implications for Daily Life

Suvorexant presents a promising new treatment for insomnia, but it is crucial to be aware of potential side effects. Always follow your doctor's instructions regarding dosage and timing. Refrain from driving or operating hazardous machinery. Suvorexant is contraindicated for individuals with narcolepsy. If you experience sleep disorders, consult your doctor for appropriate diagnosis and treatment.

Limitations of Current Research

The long-term safety and efficacy of suvorexant remain under investigation. Additionally, its use may be restricted in certain populations, including pregnant or breastfeeding women, children, and the elderly. Suvorexant can also interact with other medications, emphasizing the importance of consulting your doctor before taking it.

Future Research Directions

Future research should focus on evaluating the long-term safety and efficacy of suvorexant. Studies are also needed to understand how suvorexant affects specific populations such as pregnant or breastfeeding women, children, and the elderly. Further research is also necessary to assess the potential for interactions with other medications.

Conclusion

Suvorexant presents a promising new treatment option for insomnia. However, be mindful of potential side effects. Always follow your doctor's instructions regarding dosage and timing. If you experience sleep disorders, seek medical advice for proper diagnosis and treatment.

Literature analysis of 25 papers
Positive Content
24
Neutral Content
1
Negative Content
0
Article Type
3
2
2
12
25
2.

Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis.

Author: De CrescenzoFranco, D'AlòGian Loreto, OstinelliEdoardo G, CiabattiniMarco, Di FrancoValeria, WatanabeNorio, KurtulmusAyse, TomlinsonAnneka, MitrovaZuzana, FotiFrancesca, Del GiovaneCinzia, QuestedDigby J, CowenPhil J, BarbuiCorrado, AmatoLaura, EfthimiouOrestis, CiprianiAndrea

Pharmacological treatments for insomnia

This study aimed to compare the effectiveness of different pharmacological treatments for insomnia in adults. While behavioral, cognitive, and pharmacological interventions are effective for insomnia, medications are more widely used due to resource limitations.

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

3.

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

4.

Evaluation of suvorexant for trauma-related insomnia.

Author: MellmanThomas A, BirkuKiya, SandhuIshaan, LavelaPewu, KobayashiIhori

Improved sleep
Reduced arousal

This study evaluated the efficacy of suvorexant, a dual orexin receptor antagonist (DORA), for trauma-related insomnia in a double-blind, placebo-controlled clinical trial. The study found that suvorexant treatment improved sleep quality and reduced sleep disturbances, with the potential for enhanced REMS while reducing arousal, in contrast to traditional psychotropic agents.

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.

Suvorexant in the Treatment of Difficulty Falling and Staying Asleep (Insomnia).

Author: BergerAmnon A, SottosantiEmily R, WinnickAriel, KeefeJoseph, GilbertElasaf, HasoonJamal, ThaseMichael E, KayeAlan D, ViswanathOmar, UritsIvan

Insomnia treatment

Suvorexant, an orexin receptor antagonist, specifically targets the wake-sleep cycle and shows promise in treating insomnia. This review summarizes the biological and physiological aspects of insomnia, the mechanism of action of suvorexant, and the clinical evidence supporting its use.

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

6.

Pharmacotherapy for elderly patients with delirium in a general ward setting: A retrospective study.

Author: OhsakoNoriaki, HashimotoTasuku, ShikoYuki, KawasakiYohei, NakagawaMei, OkumaTakahiro, KurataTsutomu, SuzukiHitoshi, IshigeMinoru, KikuchiShuichi

Delirium treatment
Psychotropic AEs

Non-antipsychotic medications, such as suvorexant, ramelteon, and trazodone, may be more useful than antipsychotics in the treatment of elderly patients with delirium in terms of efficacy and safety.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Prompt improvement of difficulty with sleep initiation and waking up in the morning and daytime somnolence by combination therapy of suvorexant and ramelteon in delayed sleep-wake phase disorder: a case series of three patients.

Author: IzuharaMuneto, KawanoKiminori, OtsukiKoji, HashiokaSadayuki, InagakiMasatoshi

DSWPD treatment

This case report describes three patients with delayed sleep-wake phase disorder (DSWPD) who were successfully treated with a combination therapy of suvorexant and ramelteon. The combination therapy showed promising results in advancing the patients' sleep phases and reducing daytime somnolence.

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.

Language : English

9.

Structure-based development of a subtype-selective orexin 1 receptor antagonist.

Author: HellmannJan, DrabekMatthäus, YinJie, GuneraJakub, PröllTheresa, KrausFrank, LangmeadChristopher J, HübnerHarald, WeikertDorothee, KolbPeter, RosenbaumDaniel M, GmeinerPeter

Anxiety treatment
Drug addiction treatment
Insomnia treatment
Obesity treatment
Pain treatment

This study developed a subtype-selective OX1R antagonist, JH112, that demonstrated high selectivity for OX1R over OX2R. JH112 exhibited subnanomolar affinity for OX1R and crossed the blood-brain barrier, acting as a slowly diffusing and insurmountable antagonist for G<sub>q</sub> protein activation and β-arrestin-2 recruitment at OX1R.

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

10.

Considerations and Current Trends in the Management of the Geriatric Patient on a Consultation-Liaison Service.

Author: GlassOliver M, HermidaAdriana P, HershenbergRachel, SchwartzAnn C

Geriatric treatment
Antipsychotic mortality

This review provides consultation-liaison psychiatrists with an updated resource on the treatment and management of geriatric patients. It highlights the need for cautious use of antipsychotics in dementia, the potential of melatonin and suvorexant for delirium prevention, and the importance of considering ECT for psychotic depression.

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

11.

Adverse Events Due to Insomnia Drugs Reported in a Regulatory Database and Online Patient Reviews: Comparative Study.

Author: BorchertJill S, WangBo, RamzanaliMuzaina, SteinAmy B, MalaiyandiLatha M, DineleyKirk E

Patient information
Postmarketing safety data
Reliability concerns

This abstract discusses the potential of online drug reviews as a source of postmarketing safety data but questions their reliability due to lack of professional review and verification.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Preliminary examination of the orexin system on relapse-related factors in cocaine use disorder.

Author: SuchtingRobert, YoonJin H, MiguelGuadalupe G San, GreenCharles E, WeaverMichael F, VincentJessica N, FriesGabriel R, SchmitzJoy M, LaneScott D

Craving reduction
Improved sleep

Suvorexant, an orexin receptor antagonist, showed promise in modulating relapse-related processes in cocaine use disorder, including reduced craving, improved sleep, and better inhibitory control.

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

13.

Drugs for Insomnia beyond Benzodiazepines: Pharmacology, Clinical Applications, and Discovery.

Author: AtkinTobias, ComaiStefano, GobbiGabriella

Personalized insomnia treatment
BZD/Z-drug side effects

This review analyzes the neurobiological and clinical evidence of pharmacological treatments of insomnia, excluding the benzodiazepines (BZDs) and Z-drugs.

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

15.

Suvorexant: scientifically interesting, utility uncertain.

Author: KeksNicholas A, HopeJudy, KeoghSimone

Improved sleep
Fatigue
Hallucinations
Peripheral edema
Sleep paralysis
Somnambulism
Somnolence
Xerostomia

This paper provides a brief review of suvorexant, a new hypnotic medication for the treatment of insomnia. Suvorexant works by blocking orexin receptors, which promotes wakefulness. The drug has a moderate effect on sleep onset and duration, with greater benefits observed at higher doses but also more side effects.

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.

An update of management of insomnia in patients with chronic orofacial pain.

Author: AlmozninoG, HavivY, SharavY, BenolielR

Chronic orofacial pain management
Insomnia treatment
Drug interactions
Substance abuse

This review discusses the management of chronic orofacial pain (COFP) patients with insomnia. A multidisciplinary approach is recommended, addressing both pain and insomnia using non-pharmacological and pharmacological modalities.

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

17.

Review of Safety and Efficacy of Sleep Medicines in Older Adults.

Author: SchroeckJennifer L, FordJames, ConwayErin L, KurtzhaltsKari E, GeeMegan E, VollmerKrista A, MergenhagenKari A

Improved sleep latency
Increased total sleep time
Dementia
Fractures
Residual daytime sedation
Serious injury
Somnolence

This review focuses on the safety and efficacy of medications used to treat insomnia in older adults. Cognitive behavioral therapy and sleep hygiene are considered initial therapy for insomnia. Benzodiazepines are discouraged in the geriatric population, especially for long-term use.

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

18.

Hypothalamic orexin's role in exacerbated cutaneous vasodilation responses to an anxiogenic stimulus in a surgical menopause model.

Author: FedericiLauren M, CalimanIzabela Facco, MoloshAndrei I, FitzStephanie D, TruittWilliam A, BonaventurePascal, CarpenterJanet S, ShekharAnantha, JohnsonPhilip L

Menopausal symptom treatment

Menopausal symptoms like hot flashes and sleep disturbances affect many women. This research focuses on the role of the orexin neuropeptide system, which is linked to anxiety and thermoregulation, in menopausal symptoms. Estrogen loss may lead to a hyperactive orexin system contributing to these symptoms. Orexin receptor antagonists might offer a novel non-hormonal therapy with minimal side effects.

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.

Language : English

19.

Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians.

Author: AsnisGregory M, ThomasManju, HendersonMargaret A

Improved quality of life
Sleep-related complex behaviors

This abstract reviews the state of the art of pharmacotherapy for insomnia, including FDA-approved hypnotics and off-label options. It also discusses recent label changes regarding sleep-related complex behaviors and dose reductions for zolpidem preparations in women.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Practice GuidelineGuidelines and recommendations for the diagnosis and treatment of specific medical conditions in medical practice.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Profile of suvorexant in the management of insomnia.

Author: SuttonEliza L

Improved sleep
Abnormal dreams
Driving impairment
Next-day sedation
Sleep paralysis
Suicidal ideation

Suvorexant, a dual orexin receptor antagonist, is approved for insomnia. It improves sleep but may cause side effects like abnormal dreams, sleep paralysis, and suicidal ideation.

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

21.

Suvorexant for Primary Insomnia: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.

Author: KishiTaro, MatsunagaShinji, IwataNakao

Insomnia treatment
Abnormal dreams
Dry mouth
Fatigue
Rebound insomnia
Somnolence

Suvorexant was effective in treating primary insomnia and was well tolerated.

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

22.

Orexin receptor antagonists--a patent review (2010 to August 2014).

Author: BossChristoph

Insomnia treatment

The orexin system plays a crucial role in regulating circadian rhythm, wakefulness, arousal, and emotions. Research on orexin receptor antagonists, particularly dual antagonists, has led to clinical proof of concept for the treatment of insomnia. Merck's suvorexant gained FDA approval in 2014 for insomnia management.

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.

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

24.

Discovery and development of orexin receptor antagonists as therapeutics for insomnia.

Author: WinrowC J, RengerJ J

Improved sleep quality
Dependence
Tolerance

Insomnia is a sleep disorder. This review discusses the development of orexin receptor antagonists as a new class of medications for insomnia.

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

25.

Dual orexin receptor antagonists - promising agents in the treatment of sleep disorders.

Author: PałaszArtur, LaprayDamien, PeyronChristelle, Rojczyk-GołębiewskaEwa, SkowronekRafał, MarkowskiGrzegorz, CzajkowskaBeata, KrzystanekMarek, WiaderkiewiczRyszard

Improved sleep quality

Dual antagonists of orexin receptors offer a new pharmacological approach to treat insomnia without changing sleep architecture or causing significant side-effects.

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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