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Daridorexant vs Suvorexant
Introduction
For patients struggling with insomnia, certain medications that influence the activity of specific neurotransmitters in the brain can aid in establishing a stable sleep pattern and managing symptoms. Daridorexant and Suvorexant are two such drugs that are commonly prescribed for insomnia. They each work differently within your body but both have been proven to promote sleep in patients suffering from this condition. Daridorexant is a dual orexin receptor antagonist (DORA) which targets both OX1R and OX2R receptors, thereby blocking the wake-promoting effects of orexin neuropeptides. On the other hand, Suvorexant also inhibits the action of orexin neuropeptides but it's currently not as selective between different types of orexin receptors as Daridorexant is proposed to be; meaning its effects may vary more widely among individuals.
Daridorexant vs Suvorexant Side By Side
| Attribute | Not specified for daridorexant | Belsomra |
|---|---|---|
| Brand Name | Not specified for Daridorexant | Belsomra |
| Contraindications | Should not be taken with CNS depressants like opioids or benzodiazepines; may enhance symptoms of depression | Should not be taken with CNS depressants like opioids or benzodiazepines; may enhance symptoms of depression |
| Cost | $300–$400 for a month's supply | $330 for 30 tablets (20 mg) |
| Generic Name | Daridorexant | Suvorexant |
| Most Serious Side Effect | Severe allergic reactions, sleepiness during the day, dry mouth, strange dreams | Complex sleep behavior, signs of an allergic reaction, worsening depression or suicidal thoughts |
| Severe Drug Interactions | CNS depressants | CNS depressants |
| Typical Dose | 25-50 mg/night | 10 mg, up to 20 mg/day |
What is Daridorexant?
Daridorexant, like Suvorexant, belongs to the class of drugs referred to as dual orexin receptor antagonists (DORAs), which have been a significant advancement in the treatment of insomnia. Daridorexant was most recently approved by the FDA and it functions by blocking both types of orexin receptors—Orexin 1 and Orexin 2—which are believed to play an integral role in wakefulness. By inhibiting these receptors, Daridorexant effectively promotes sleep.
On the other hand, Suvorexant also serves a similar function but has been around for longer since its approval by the FDA in 2014. Both medications are prescribed for treating insomnia characterized by difficulties with sleep onset and/or sleep maintenance.
However, where they differ is that Daridorexant has demonstrated greater selectivity for these two orexin receptors compared to Suvorexant; this results in fewer side effects such as next-day drowsiness—a common issue with many other sleeping aids.
What conditions is Daridorexant approved to treat?
Daridorexant is approved for the treatment of insomnia, including:
- Insomnia characterized by difficulties with sleep onset
- Difficulties with sleep maintenance
Suvorexant, on the other hand, is also used to treat various types of insomnia:
- Sleep-onset insomnia where people struggle to fall asleep at the beginning of their sleep cycle
- Sleep-maintenance insomnia where individuals have difficulty staying asleep throughout the night
How does Daridorexant help with these illnesses?
Daridorexant helps to manage insomnia by blocking the action of orexin, a neurotransmitter in the brain that plays a crucial role in wakefulness and arousal. It does this by binding to orexin receptors, preventing it from triggering the neural pathways that promote wakefulness. Orexin is involved in controlling alertness, appetite, reward systems and energy regulation among other things. In people with insomnia or sleep disorders, there may be an overactivity of these orekinergic neurons promoting excessive wakefulness. Therefore, by blocking the effects of orexin through Daridorexant's antagonistic mechanism on its receptors, it aids patients to fall asleep faster and maintain their sleep throughout the night without interruptions—thus improving overall sleep quality.
What is Suvorexant?
Suvorexant is marketed under the brand name Belsomra, and it is a type of medication known as an orexin receptor antagonist. This means it functions by blocking the activity of a neurotransmitter in the brain called orexin, which plays a vital role in wakefulness and arousal. Suvorexant was first approved by the FDA in 2014 for use as a sleep aid, particularly for those struggling with insomnia. Unlike many traditional hypnotics or sedatives, suvorexant does not work through enhancing GABAergic transmission. Its unique mechanism of action results in a different side-effect profile compared to other commonly prescribed sleeping aids: It's less likely to cause hangover-like effects upon waking up or dependency over prolonged use (common issues associated with benzodiazepines and barbiturates). The effectiveness of suvorexant can be beneficial for patients who do not respond well to "typical" hypnotic drugs or prefer an alternative with lower risk of dependence.
What conditions is Suvorexant approved to treat?
Suvorexant is an FDA-approved drug for the treatment of:
- Insomnia characterized by difficulties with sleep onset and/or sleep maintenance This medication belongs to a class known as orexin receptor antagonists, which work uniquely by inhibiting the action of neurotransmitters known as orexins that play a significant role in wakefulness.
How does Suvorexant help with these illnesses?
Suvorexant is a unique medication that works by blocking the action of orexin, a neurotransmitter which plays roles in wakefulness and arousal. By inhibiting the activity of orexin, Suvorexant aids in promoting sleep for those suffering from insomnia. As with other neurotransmitters like norepinephrine or serotonin, an imbalance in orexin may lead to sleep disturbances. Different from traditional sleep medications that work on GABA receptors, Suvorexant specifically targets the orexin system and does not tend to cause next-day grogginess often associated with such treatments. While Daridorexant also operates on this pathway, it is newer and less studied than Suvorexant. Thus, physicians might opt to prescribe Suvorexant when patients do not respond well to typical sedative-hypnotics or are seeking an alternative mechanism of action for their insomnia treatment.
How effective are both Daridorexant and Suvorexant?
Both Daridorexant and Suvorexant are newer medications developed for the treatment of insomnia. These drugs were each approved by regulatory authorities a few years apart, with Suvorexant gaining FDA approval in 2014 and Daridorexant being more recently approved. Both medications act on a similar principle, targeting orexin receptors to reduce wakefulness and thereby promote sleep.
The effectiveness of both daridorexant and suvorexant has been studied extensively in clinical trials. A study published in 2020 found that daridorexant significantly improved sleep onset latency, wake after sleep onset, and subjective total sleep time compared to placebo over three months of nightly use. Similarly, suvorexant was also found to be effective at reducing these measures of insomnia severity according to several studies.
A review published in 2019 highlighted that suvorexant improves sleep efficiency and reduces nighttime awakenings without causing serious adverse effects such as daytime sedation or cognitive impairment often seen with other hypnotics like benzodiazepines. The same study reported that patients treated with suvorexant had significant improvement in their quality of life related to better sleep quality.
Meanwhile, another review from 2021 concluded that daridorexan's efficacy is comparable if not superior to existing treatments for insomnia including suvorexnats based on available evidence so far; however further long-term comparative studies are needed before definitive conclusions can be made about its relative position among treatments for insomnia. Nonetheless due its unique pharmacological profile targeting specific orexin receptors involved maintaining wakefulness it may offer an additional option for those struggling managing their symptoms using existing therapies.
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At what dose is Daridorexant typically prescribed?
Oral dosages of Daridorexant range from 25-50 mg/night, but research suggests that 25 mg/night is sufficient for treating insomnia in most individuals. Unlike Prozac, this medication isn't recommended for children or adolescents. In adults, dosage can be increased to 50 mg if there's no response after a few weeks. The maximum dosage that should not be exceeded in any case is 50 mg/night. Similarly, Suvorexant has an oral dose ranging between 5–20 mg/night and the starting dose is usually at the lower end of this scale; however, it can also be increased if required but shouldn't exceed 20mg per night.
At what dose is Suvorexant typically prescribed?
Suvorexant treatment typically begins with a dosage of 10 mg taken orally once per day, right before bedtime. The dose can be increased to a maximum of 20 mg/day if the initial dosage does not effectively aid in sleep after some time. This is usually determined by your healthcare provider based on your response and tolerance to the medication. It's important that when taking Suvorexant, you have at least 7 hours to dedicate to sleeping before being active again, as it can cause drowsiness or impair your thinking skills for several hours after waking up. Always take Suvorexant exactly as directed by your healthcare provider.
What are the most common side effects for Daridorexant?
Common side effects that might be experienced with daridorexant include:
- Somnolence (sleepiness/drowsiness)
- Fatigue
- Dry mouth
- Abnormal dreams
While common side effects associated with suvorexant are similar, they may also include:
- Unusual dizziness or lightheadedness
- Sleep paralysis
- Nightmares or unusual dreams
- Temporary inability to move or talk for up to several minutes while falling asleep or waking up.
Remember it's essential to discuss any concerning symptoms you experience with your healthcare provider, who can provide guidance on whether these medications are suitable for you.
Are there any potential serious side effects for Daridorexant?
While both Daridorexant and Suvorexant are used to treat insomnia, their potential side effects differ. For Daridorexant:
- There is a risk of severe allergic reactions including hives, difficulty breathing, swelling in your face or throat.
- Some reported side effects include sleepiness during the day, dry mouth or strange dreams
- It may cause drowsiness so do not drive or operate machinery until you know how it affects you.
For Suvorexant:
- The most serious possible side effect is complex sleep behavior: actions such as sleep-walking or driving while asleep.
- Other symptoms can include temporary leg weakness, and extreme drowsiness that persists into the next day.
- Just like with many other medications, there's also a risk of an allergic reaction such as rash; itching/swelling (especially of the face/tongue/throat); severe dizziness; trouble breathing.
In either case if any adverse symptoms occur stop taking medication and consult with your doctor right away.
What are the most common side effects for Suvorexant?
When considering Suvorexant, potential side effects can include:
- Daytime drowsiness or sedation
- Headaches and dizziness
- Abnormal dreams or nightmares
- Dry mouth
- Unusual feelings of tiredness or weakness
- Sleep disturbances such as sleep-walking, sleep-driving, and engaging in other activities while not fully awake. Remember to discuss these possible symptoms with your healthcare provider before starting Suvorexant for insomnia treatment.
Are there any potential serious side effects for Suvorexant?
When using Suvorexant, there are some potential side effects to be aware of:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat.
- Complex sleep behaviors like sleep-walking or engaging in activities while not fully awake and having no memory of them after waking up. These could potentially lead to serious injuries.
- Worsening depression or suicidal thoughts
- Anxiety, hallucinations (seeing or hearing things that aren't real), feeling as if you might pass out
- Daytime drowsiness - do not drive until you know how this medication will affect you. If any of these symptoms occur after taking suvorexant, it's crucial to contact a healthcare professional immediately. It is also essential to report any unusual behavioral changes directly away.
Contraindications for Daridorexant and Suvorexant?
Both daridorexant and suvorexant, along with most other sleep aid medications, may enhance symptoms of depression in some individuals. If you notice your depression symptoms worsening or an increase in suicidal thoughts or behavior while taking these medications, please seek immediate medical attention.
Neither daridorexant nor suvorexant should be taken if you are consuming any CNS depressants (like opioids or benzodiazepines). Always inform your physician about the medications you are currently on; CNS depressants will require careful monitoring due to their potential to cause additive effects such as severe drowsiness and respiratory problems when combined with insomnia drugs like daridorexant or suvorexant.
How much do Daridorexant and Suvorexant cost?
For the brand-name versions of these drugs:
- The price of 30 tablets of Suvorexant (Belsomra, 20 mg) averages around $330, which works out to about $11/day.
- Daridorexant is a newer drug and precise pricing information may not be readily available. However, new branded medications for insomnia typically cost in the range of $300–$400 for a month's supply (30 tablets), which equates to approximately $10–$13 per day.
Thus, if you are in the higher dosage range for Suvorexant (i.e., taking 20mg per day), then brand-name Daridorexant could potentially be similarly priced or slightly more expensive on a per-day treatment basis. Please note that cost should not be your primary consideration when determining which medication is best suited for you. Consult with your healthcare provider regarding efficacy, side effects and other factors.
At present time there are no generic forms available for either Daridorexant or Suvorexant as both medications are still under patent protection. Therefore their costs remain high compared to older sleep aids that have generic alternatives.
Popularity of Daridorexant and Suvorexant
Daridorexant and suvorexant are both used as sleep aids, specifically targeting insomnia through their function as dual orexin receptor antagonists.
Suvorexant, also known by the brand name Belsomra, was first approved for use in 2014. In 2020, it was estimated that about half a million people were prescribed this medication in the US. Over time, its usage has increased with more awareness of its benefits over traditional hypnotic drugs due to fewer side-effects like next-day drowsiness.
On the other hand, daridorexant is still relatively new on the market after receiving approval from regulatory authorities just recently. As such, concrete data regarding prescription numbers isn't readily available yet. However, early clinical trials suggest that it may be comparable or possibly superior to suvorexant in terms of reducing wakefulness during sleep while also maintaining a low side-effect profile. This could result in an increase in prescriptions once it becomes more established within medical practice.
Conclusion
Both Daridorexant and Suvorexant are used in the treatment of insomnia, with numerous clinical studies indicating their efficacy over placebo treatments. They work by inhibiting the action of orexin, a neurotransmitter that plays a role in wakefulness. However, their use should be carefully considered as they can interact negatively with other medications.
Daridorexant is newer to the market than Suvorexant and shows potential for fewer side effects due to its selective mechanism of action on orexin receptor type 2 (OX2R). It also has demonstrated an improved ability to maintain sleep throughout the night when compared to older drugs like Suvorexant which acts non-selectively on both OX1R and OX2R receptors.
Currently, only Suvorexant is available in generic form allowing for more cost-effective accessibility for patients paying out of pocket. Both Daridorexant and Suvorexant may require an adjustment period before effects become noticeable.
The side effect profile between these two drugs differs, with both being generally well-tolerated but Daridorexant potentially causing less daytime drowsiness than Suvorexant due to its selectivity towards OX2R. Patients should closely monitor any changes especially when starting treatment or altering dosage levels and seek immediate medical assistance if they experience unusual symptoms such as worsening insomnia or abnormal behaviors during sleep.
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Refrences
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