Suvorexant for insomnia in older adults: a perspective review

Abstract

The aim of this review was to identify published randomized control trials (RCTs) that evaluated the efficacy and tolerability of suvorexant for the treatment of insomnia among older adults (≥65 years). A literature search was conducted of PubMed, MEDLINE, EMBASE, PsycINFO and Cochrane collaboration databases for RCTs in any language evaluating suvorexant for the treatment of insomnia in older adults. Additionally, references of full-text articles that were included in this review were searched for further studies. Data from three RCTs of suvorexant were included in this review. All the three studies fulfilled the criteria for being of good quality based on the items listed by the Center for Evidence Based Medicine (CEBM) for the assessment of RCTs. None of the three studies were conducted exclusively among older adults. However, they also included older individuals diagnosed with primary insomnia. These studies included a total of 1298 participants aged ≥65 years in age. Trial durations ranged from 3 months to 1 year. Available data from these studies indicate that suvorexant improves multiple subjective and polysomnographic sleep parameters for sleep onset and maintenance among older individuals with a diagnosis of primary insomnia and is generally well tolerated. Current evidence, although limited, indicates that suvorexant benefits older adults with primary insomnia and is generally well tolerated.

Efficacy of Orexin Receptor Antagonist for Delirium after Coronary Artery Bypass Grafting Compared with Melatonin Receptor Agonist

“…Suvorexant is reported to be a new type of sleep medication that has no affinity for an alpha-aminobutyric acid receptor (GABAR) 6) , and can be safely used for the treatment of insomnia in older adults 13) . In addition, Suvorexant is reported to be associated with a low incidence of delirium in ICU patients.…”

Insomnia

“…While much of the research about dual orexin receptor antagonists focuses on the relative safety and tolerability of these medications in people 65 years old and older, 56 it should be noted that nonbenzodiazepine GABA receptor agonists were once similarly promoted in comparison to benzodiazepines; it took several years before prescribers were alerted to the concerning adverse effects of nonbenzodiazepine GABA receptor agonists. HISTAMINE.…”

Sleep disturbances in temporomandibular disorders: a narrative review

“…Their effects are usually immediate and can have lower cost than CBT, but may be accompanied by side effects, drug-drug interactions, short-term efficacy and a risk of addiction 3 . Medications that can be used to treat sleep but with less evidence of their effects on pain are the atypical antidepressant trazodone, the hypnotic agent zolpidem or the orexin receptor antagonist suvorexant [107][108][109] . Evidence indicates that benzodiazepines such as diazepam or clonazepam, can be beneficial for improving sleep and reducing pain outcomes in chronic pain populations including TMD 110 .…”