Opinion
Video
Dual-Orexin Receptor Antagonists for Treatment of Insomnia
Author(s):
In an upcoming Peer Exchange program entitled “Dual-Orexin Receptor Antagonists for Treatment of Insomnia” Dr Paul Doghramji will moderate a conversation with physicians about this class of agents for treatment of insomnia and discuss other therapeutic advancements in the field.
Summary
This is a video synopsis of a discussion involving Dr Paul Doghramji, a distinguished family physician practicing at Collegeville Family Practice and serving as the Medical Director of Health Services at Ursinus College, both located in Collegeville, Pennsylvania. Dr Doghramji introduces an upcoming Peer Exchange program titled "Dual Orexin Receptor Antagonists for Treatment of Insomnia."
In this program, Dr Doghramji will moderate a conversation with esteemed colleagues regarding the use of dual orexin receptor antagonists and other therapeutic advancements in treating insomnia. The discussion covers several key topics, starting with the standard of care for insomnia and the associated challenges.
Dr Doghramji emphasizes that cognitive behavioral therapy is considered the best treatment for chronic insomnia. However, challenges arise as many patients struggle to find therapists or commit to the recommended duration of therapy. Consequently, medication becomes a prominent option, and Dr Doghramji outlines various FDA-approved categories, including benzodiazepines, selective benzodiazepine receptor agonists, melatonin receptor agonists, and others.
The discussion introduces the newest entrants in insomnia treatment—dual orexin receptor antagonists. Dr Doghramji explains that these medications block the effects of orexin, a neurotransmitter promoting wakefulness. The three approved medications in this category, suvorexant, lemborexant, and daridorexant, have shown efficacy in helping patients both initiate and maintain sleep.
Dr Doghramji provides a comprehensive comparison of traditional treatments and dual orexin receptor antagonists, emphasizing the latter's advantages, including no tolerance, no rebound effects, and no withdrawal symptoms. Additionally, he highlights unique features of daridorexant, such as improved efficacy over time and a positive impact on next day sleepiness at higher doses.
In conclusion, Dr Doghramji introduces these dual orexin receptor antagonists as a promising category of medications with potential benefits for patients experiencing insomnia, addressing some of the challenges associated with traditional treatments.
Video synopsis is AI-generated and reviewed by Neurology Live® editorial staff.
