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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jrbecker76 on August 13, 2014, at 16:07:13
Suvorexant will undoubtedly be an interesting new drug in the hypnotic category given that it represents an entirely new class known as orexin antagonists. However, there should be some caution in prescribing it to those with co-morbid psychiatric diagnoses. In clinical trials, suvorexant subjects were found to have a slightly higher but significant incidence of suicidal ideation (but not depression) in comparison with placebo. Further consumer experience once it launches will hopefully provide more insight on this risk.
Posted by babbler20 on August 13, 2014, at 16:38:50
In reply to FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by jrbecker76 on August 13, 2014, at 16:07:13
This is awesome. I have been waiting for this. Thank you.
Posted by linkadge on August 13, 2014, at 16:39:45
In reply to FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by jrbecker76 on August 13, 2014, at 16:07:13
Interesting. I wonder how such an agent 'feels'. All I know for sleep is benzos and antihistamines. I wonder if an orexin antagonist would be useful for anxiety.
Linkadge
Posted by Phillipa on August 13, 2014, at 18:28:07
In reply to FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by jrbecker76 on August 13, 2014, at 16:07:13
Sounds dangerous to me. Will stick with benzos. Phillipa
Posted by Beckett on August 13, 2014, at 23:49:56
In reply to FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by jrbecker76 on August 13, 2014, at 16:07:13
I wonder how it effects sleep architecture.
Is there use of orexin as an alerting agent?
Posted by BrainDamage on August 15, 2014, at 8:06:40
In reply to Re: FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by Beckett on August 13, 2014, at 23:49:56
I'd be concerned that it would cause or worsen Depression
I remember reading about someone having a bad response to an orexingenic drug, during a trial
But I can't remember whether it was an Agonist or Antagonist
I thought Adrafanil was "possibly" thought to work as an Orexin agonist?
That seemed to have good AD affects to me
Posted by babbler20 on August 15, 2014, at 23:20:20
In reply to FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by jrbecker76 on August 13, 2014, at 16:07:13
Just read that when tested on 1,000 people, they were falling asleep 8 minutes faster than those on placebo and sleeping 20 minutes longer. 20 minutes? Are you kidding me?
Posted by ed_uk2010 on August 19, 2014, at 13:34:28
In reply to Re: FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by babbler20 on August 15, 2014, at 23:20:20
>20 minutes? Are you kidding me?
No, the effect of hypnotics on this time of sleep parameter often isn't very great. One of the benefits of conventional sleep aids such as the benzodiazepines is that they reduce anxiety, restlessness and distress during the night. In general, sleep aids should be avoided for patients who are not distressed by their insomnia, because they are not usually worthwhile. Reduction of distress is a major purpose for the prescription.
Hypnotics should not normally be Rxed in an attempt to improve daytime functioning, because they generally worsen it. This has been shown to happen very frequently even with short-acting hypnotics. The risk of car accidents etc. is increased, even in those who do not recognise that they are impaired.
Prescribing guidelines vary between countries. In the UK, night sedation is recommended for...
'the short-term treatment of insomnia in cases where it is severe, disabling or subjecting the individual to extreme distress'.
Posted by ed_uk2010 on August 19, 2014, at 13:46:09
In reply to Re: FDA Approves BELSOMRA® (suvorexant) for Sleep, posted by babbler20 on August 15, 2014, at 23:20:20
I forgot to mention, another use for hypnotics is in bipolar disorder and psychotic illness, in pts whose symptoms worsen in response to sleep deprivation. Having said that, insomnia is often difficult to treat effectively, and rebound from medication can be a major problem. Time will tell for Belsomra...
Posted by babbler20 on August 19, 2014, at 14:45:16
In reply to Re: FDA Approves BELSOMRA® (suvorexant) for Sleep » babbler20, posted by ed_uk2010 on August 19, 2014, at 13:34:28
Thanks for the info. Hopefully they will come out with something in my lifetime that will keep me asleep.
This is the end of the thread.
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