Dual Orexin Receptor Antagonists for Treatment of Insomnia: Review of Suvorexant and Lemborexant
Keywords:
insomnia, dual orexin receptor antagonists, suvorexant, lemborexantAbstract
Insomnia is an important problem in healthcare systems since it affects quality of life, working, and increases risk of certain disease. Although, Benzodiazepines and non-benzodiazepine are the major classes of prescribed medication for insomnia, the long-term treatment is still questionable including drug dependence, complex sleep behavior, memory and learning impairment. The new class of medication for treatment of insomnia, dual orexin receptor antagonists, were proposed to promote sleep and decrease wakefulness via competitively binding to orexin 1 and orexin 2 receptor. Suvorexant and lemborexant are dual orexin receptor antagonists approved by U.S.FDA. for treatment of insomnia. The efficacy including deceased sleep onset latency and increased total sleep time were reported. Also, the effectiveness and safety over long-term treatment without dependence and withdrawal symptoms as well as no complex sleep behavioral were observed. The study suggested that efficacy and safety of dual orexin receptor antagonists were dose-related. Lemborexant presented superior efficacy with higher side-effect compared to suvorexant. In conclusion, suvorexant and lemborexant are an alternative treatment for insomnia, especially in people who suffered from the side-effect or had contraindicated of other sleep medication. However, the efficacy and safety of dual orexin receptor antagonist still needs further investigation.
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