Can orexin receptor antagonist offer a future option in pharmacological management of insomnia in older adults?
Tsang, Yuk Ting Mishriky, Raafat Girgis, Eriny Antoun Reyad, Ayman
Tsang, Yuk Ting
Mishriky, Raafat
Girgis, Eriny
Antoun Reyad, Ayman
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Affiliation
University of Wolverhampton; Hamad Medical Corporation, Qatar; Coventry and Warwickshire Partnership Trust
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Publication date
2024-10
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Abstract
Insomnia is a sleep condition in the general population including older adults. Pharmacological treatments may have limited efficacy and unacceptable side effects profile for the older population. Daridorexant, a dual orexin receptor antagonist has shown promise in improving some sleep parameters. We discuss its clinical application and efficacy in this article. Methods: We searched databases including PubMed and Science Direct and checked clinical trials that determined its efficacy using parameters such as wake time after sleep onset (WASO), latency to persistent sleep (LPS) and total sleep time (TST), at different doses. Results: Small doses such as 5 and 10 mg did not show clinical efficacy, while 25mg and 50mg were superior in improving the efficacy outcomes with mild adverse reactions. Daridorexant reduced wake time after sleep onset (WASO), latency to persistent sleep (LPS), whilst increasing total sleep time (sTST). It was associated with a mild risk of headache and fatigue but did not cause other adverse associated with traditional therapies, such as withdrawal or rebound insomnia. This review supports clinicians such as psychiatrists, physicians and pharmacists in choosing the best treatment options taking into consideration patients’ conditions and preferences. The authors do not recommend prescribing before more longitudinal and larger studies.
Citation
Tsang, Y.T., Mishriky, R., Girgis, E. and Antoun Reyad, A. (2024) Can orexin receptor antagonist offer a future option in pharmacological management of insomnia in older adults? Arabian Journal of Older Adults Mental Health Disorders, October 2024.
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Article