Suvorexant: Difference between revisions
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Expand Suvorexant with Stahl-sourced detail (with skepticism) |
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{{MedTemplate | {{MedTemplate | ||
| brand = Belsomra | | brand = Belsomra | ||
| classes = Dual orexin receptor antagonist (DORA) | | classes = Dual orexin receptor antagonist (DORA), the first approved | ||
| mechanism = Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. | | mechanism = Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. | ||
| uses = Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. | | uses = Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. | ||
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| pregnancy = Limited data; avoid | | pregnancy = Limited data; avoid | ||
| legal = Rx, Schedule IV (US) | | legal = Rx, Schedule IV (US) | ||
| intro = '''Suvorexant''' (brand name Belsomra) is the first FDA-approved dual orexin receptor antagonist (DORA), approved August 2014 for insomnia. Suvorexant established the DORA class as a treatment paradigm | | intro = '''Suvorexant''' (brand name Belsomra) is the first FDA-approved dual orexin receptor antagonist (DORA), approved August 2014 for insomnia. Suvorexant established the DORA class as a treatment paradigm, reducing arousal via orexin blockade rather than enhancing GABA-mediated inhibition. Subsequent DORAs (lemborexant 2019, daridorexant 2022) have been positioned as iterative improvements with different pharmacokinetics. | ||
Suvorexant has been studied in mild-moderate Alzheimer disease with positive results; trials have suggested potential for reducing sleep-disordered breathing exacerbations and possibly delaying cognitive decline (though the cognitive claim remains controversial). | Suvorexant has been studied in mild-moderate Alzheimer disease with positive results; trials have suggested potential for reducing sleep-disordered breathing exacerbations and possibly delaying cognitive decline (though the cognitive claim remains controversial). | ||