Psychiatr. praxi. 2023;24(3):176-179 | DOI: 10.36290/psy.2023.033

New pharmaceuticals in the treatment of insomnia

MUDr. Jozef Višňovský, MUDr. Jakub Vaněk
Klinika psychiatrie, Fakultní nemocnice Olomouc

Sleep disorders are among the most common reasons why patients seek general practitioners or psychiatrists. The annual prevalence of insomnia in the adult population is estimated at up to 40%. Sleep disorders can occur in isolation or in combination with another underlying disorder. Non-pharmacological measures and procedures, even though they are an integral part of insomnia therapy, are not always preferred by patients and even doctors. Pharmacotherapy of sleep disorders includes a wide spectrum of drugs. Sleep medicine and its research are constantly evolving, which also brings new pharmaceuticals. The aim of the article is to provide a brief overview of the basic properties and use of new drugs in the treatment of insomnia. Namely, melatonin receptor agonists and dual orexin receptor antagonists are represented in the article. Even though these drugs are still used marginally in practice, they have a their place in the therapy of sleep disorders. When indicated correctly, they can bring significant benefits to patients in the form of quality sleep.

Keywords: pharmacotherapy, sleep, insomnia, melatonin, orexin, insomnia.

Accepted: October 9, 2023; Published: October 16, 2023  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Višňovský J, Vaněk J. New pharmaceuticals in the treatment of insomnia. Psychiatr. praxi. 2023;24(3):176-179. doi: 10.36290/psy.2023.033.
Download citation

References

  1. Morin CM, Jarrin DC. Epidemiology of insomnia: prevalence, course, risk factors, and public health burden. Sleep Medicine Clinics. 2022;17(2),173-191. Go to original source... Go to PubMed...
  2. Kec D, Ludka O, Hamerníková V, et al. Současné trendy v léčbě a diagnostice chronické nespavosti. Česká a Slovenská Psychiatrie. 2020;116(3).
  3. Siebern AT, Suh S, Nowakowski S. Non­‑pharmacological treatment of insomnia. Neurotherapeutics. 2012;9,717-727. Go to original source... Go to PubMed...
  4. Asaad T. Sleep in ancient Egypt. Sleep Medicine: A Comprehensive Guide to Its Development, Clinical Milestones, and Advances in Treatment. 2015;13-19. Go to original source...
  5. Liu J, Clough SJ, Hutchinson AJ, et al. MT1 and MT2 Melatonin Receptors: A Therapeutic Perspective. Annu Rev Pharmacol Toxicol. 2016;56:361-83. Go to original source... Go to PubMed...
  6. Lyseng­‑Williamson KA. Melatonin prolonged release: in the treatment of insomnia in patients aged ≥ 55 years. Drugs Aging. 201;29(11):911-23. Go to original source... Go to PubMed...
  7. MacIsaac SE, Carvalho AF, Cha DS, et al. The mechanism, efficacy, and tolerability profile of agomelatine. Expert Opin Pharmacother. 2014;15(2):259-74. Go to original source... Go to PubMed...
  8. Nesnídal M. V. Agomelatin-tolerance s velkým účinkem. Psychiatr. praxi. 2019; 20(2): 88-91. Go to original source...
  9. MacIsaac SE, Carvalho AF, Cha DS, et al. The mechanism, efficacy, and tolerability profile of agomelatine. Expert Opin Pharmacother. 2014;15(2):259-74. Go to original source... Go to PubMed...
  10. Carney RM, Shelton RC. Agomelatine for the treatment of major depressive disorder. Expert Opin. Pharmacother. 2011;12:2411-2419. Go to original source... Go to PubMed...
  11. Dolder CR, Nelson M, Snider M. Agomelatine treatment of major depressive disorder. Ann. Pharmacother. 2008;42:1822-1831. Go to original source... Go to PubMed...
  12. Sansone RA, Sansone LA. Agomelatine: A novel antidepressant. Innov. Clin. Neurosci. 2011;8:10-14.
  13. Dubovsky SL, Warren C. Agomelatine, a melatonin agonist with antidepressant properties. Expert Opin. Investig. Drugs. 2009;18:1533-1540 Go to original source... Go to PubMed...
  14. Howland RH. A benefit­‑risk assessment of agomelatine in the treatment of major depression. Drug Saf. 2011;34:709-731. Go to original source... Go to PubMed...
  15. Kohsaka M, Kanemura T, Taniguchi M, et al. Efficacy and tolerability of ramelteon in a double­‑blind, placebo­‑controlled, crossover study in japanese patients with chronic primary insomnia. Expert Rev. Neurother. 2011;11:1389-1397. Go to original source... Go to PubMed...
  16. Dhillon S, Clarke M. Tasimelteon: First global approval. Drugs. 2014;74:505-511. Go to original source... Go to PubMed...
  17. Lockley SW, Dressman MA, Xiao C, et al. Tasimelteon treatment entrains the circadian clock and demonstrates a clinically meaningful benefit in totally blind individuals with non-24-hour circadian rhythms [abstract no. FP26-6]. 95th Annual Meeting of the Endocrine Society; 15-18 Jun 2013; San Fransisco, CA. Go to original source...
  18. Feeney J, Birznieks G, Scott C, et al. Melatonin agonist tasimelteon improves sleep in primary insomnia characterized by difficulty falling asleep. Sleep. 2009;32 Suppl:A43.
  19. Rajaratnam SM, Polymeropoulos MH, Fisher DM, et al. Melatonin agonist tasimelteon (VEC-162) for transient insomnia after sleep­‑time shift: two randomised controlled multicentre trials. Lancet. 2009;373(9662):482-91. Go to original source... Go to PubMed...
  20. Eggermann E, Serafin M, Bayer L, et al. Orexins/hypocretins excite basal forebrain cholinergic neurones. Neuroscience. 2001;108(2):177-181. Go to original source... Go to PubMed...
  21. Yamanaka A, Tsujino N, Funahashi H, et al. Orexins activate histaminergic neurons via the orexin 2 receptor. Biochem Biophys Res Commun. 2002;290(4):1237-1245. Go to original source... Go to PubMed...
  22. Kuriyama A, Tabata H. Suvorexant for the treatment of primary insomnia: a systematic review and meta­‑analysis. Sleep Medicine Reviews. 2017; 35, 1-7. Go to original source... Go to PubMed...
  23. Sun Y, Tisdale RK, Kilduff TS. Hypocretin/Orexin Receptor Pharmacology and Sleep Phases. Front Neurol Neurosci. 2021;45:22-37. Go to original source... Go to PubMed...
  24. Markham A. Daridorexant: First Approval. Drugs. 2022;82(5):601-607. Go to original source... Go to PubMed...
  25. Boss C, Gatfield J, Brotschi C, et al. The Quest for the Best Dual Orexin Receptor Antagonist (Daridorexant) for the Treatment of Insomnia Disorders. ChemMedChem. 2020;15(23):2286-2305. Go to original source... Go to PubMed...
  26. Mahler SV, Smith RJ, Moorman DE, et al. Multiple roles for orexin/hypocretin in addiction. Progress in brain research. 2012;198,79-121. Go to original source... Go to PubMed...
  27. Elliott W, Chan J. Daridorexant Tablets (Quviviq). Internal Medicine Alert. 2022;44(7).
  28. Zammit G, Dauvilliers Y, Pain S, et al. Daridorexant, a new dual orexin receptor antagonist, in elderly subjects with insomnia disorder. Neurology. 2020;94(21):e2222-e2232. Go to original source... Go to PubMed...
  29. Mignot E, Mayleben D, Fietze I, et al. Safety and efficacy of daridorexant in patients with insomnia disorder: results from two multicentre, randomised, double­‑blind, placebo­‑controlled, phase 3 trials. The Lancet Neurology. 2022;21(2),125-139. Go to original source... Go to PubMed...
  30. Schilling U, Henrich A, Muehlan C, et al. Impact of Daridorexant, a Dual Orexin Receptor Antagonist, on Cardiac Repolarization Following Bedtime Dosing: Results from a Thorough QT Study Using Concentration­‑QT Analysis. Clin Drug Investig. 2021;41(8):711-721. Go to original source... Go to PubMed...
  31. Muehlan C, Brooks S, Vaillant C, et al. Driving performance after bedtime administration of daridorexant, assessed in a sensitive simulator. Clinical Pharmacology & Therapeutics. 2022;111(6),1334-1342. Go to original source... Go to PubMed...
  32. Leger D, Fietze I, Pain S, et al. Absence of withdrawal symptoms and rebound insomnia upon discontinuation of daridorexant in patients with insomnia. Sleep. 2021;44(Supplement_2), A139-A139. Go to original source...




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.