Assessment of Switching to Suvorexant versus the Use of Add-on Suvorexant in Combination with Benzodiazepine Receptor Agonists in Insomnia Patients: A Retrospective Study.
10.9758/cpn.2018.16.2.184
- Author:
Masakazu HATANO
1
;
Hiroyuki KAMEI
;
Risa INAGAKI
;
Haruna MATSUZAKI
;
Manako HANYA
;
Shigeki YAMADA
;
Nakao IWATA
Author Information
1. Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan.
- Publication Type:Original Article
- Keywords:
Suvorexant;
Orexin receptor antagonists;
Benzodiazepines;
Insomnia;
Adverse effects
- MeSH:
Benzodiazepines*;
Humans;
Methods;
Orexin Receptor Antagonists;
Prescriptions;
Receptors, GABA-A*;
Retrospective Studies*;
Risk Factors;
Sleep Initiation and Maintenance Disorders*
- From:Clinical Psychopharmacology and Neuroscience
2018;16(2):184-189
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Suvorexant is a novel hypnotic drug that does not interact with the conventional γ-aminobutyric acid (GABA)-A receptor. We investigated the method by which suvorexant was introduced in insomnia patients who were taking benzodiazepine receptor agonists (BzRA). METHODS: This was a retrospective study. We extracted clinical data for patients who were prescribed suvorexant and were already using BzRA. The patients were assigned to two groups, the switching and add-on groups. We assessed the suvorexant discontinuation rate at one month after the prescription of the drug. RESULTS: One hundred and nineteen patients were assigned to the switching group, and 109 were assigned to the add-on group. The add-on group exhibited a significantly higher all-cause discontinuation rate than the switching group (odds ratio, 2.7; 95% confidence interval, 1.5 to 5.0; adjusted p < 0.001). Intolerability was a significantly stronger risk factor for suvorexant discontinuation in the add-on group (22.0% vs. 7.6%, p < 0.002), and the most common adverse effect was oversedation. CONCLUSION: Our results show that the add-on of suvorexant increases the frequency of oversedation compared with switching in insomnia patients that are taking BzRA. However, this was only a preliminary retrospective study, and further studies will be required to confirm our findings.
