Daridorexant a molecule that acts on the orexin system: the first of this class of drugs authorized in Europe. Ferini-Strambi: It has a half-life of 7-8 hours and can also be used by those suffering from sleep apnea
We have one more weapon to fight insomnia
. Is called daridorexant and a molecule that acts on the system oforexina, a neurotransmitter produced by the hypothalamus capable of regulating sleep-wake rhythm, appetite and even mood through its action on two receptors, called OXR1 and OXR2. The drug, approved by the FDA (Food and drug administration) in the United States a year ago and by the European Medicines Agency last April, now also available in Italy.
The mechanism of action not new: other so-called drugs orexinergic (class DORA, dual orexin receptor antagonists) have been developed (e.g. suvorexant was approved by the FDA in 2014 and lemborexant in 2020), but daridorexant the first to receive the green light in Europe. In studies, randomized and controlled with placebo, its effectiveness has been high in reducing the time it takes to fall asleep and wake up at night, the two biggest problems for sufferers of insomnia.
Compared to previous drugs of the same class, daridorexant has a big advantage, which is a half-life of 7-8 hours,” he says Luigi Ferini-Strambi, director of the Sleep Medicine Center at the IRCCS San Raffaele Hospital in Milan and full professor of Neurology at the Vita-Salute San Raffaele University —. This means that the effect of the medicine wears off during the night, without the risk of side effects (drowsiness) in the morning or during the day. In addition daridorexant, usable in subjects aged 18 and over, it has a particularly marked effect in the elderlyas shown by published studies.
We speak of insomnia when the difficulty in falling asleep and/or frequent awakenings at night or in the early hours of the morning become chronic, i.e. they appear more than three nights a week and for at least three months. To treat insomnia (which can have a very heavy impact even during the day, in fact we speak of 24-hour sickness) there are various therapeutic options, such as sleeping pills, especially benzodiazepines, and so-called Z-drugs (zolpidem, zopiclone, eszopiclone). Very often patients also find benefit in cognitive-behavioral psychotherapy. However, the arrival of daridorexant is important – says the San Raffaele neurologist -: the drug can be of great help to people who fail to “turn off the brain”. It is a definite condition hyperarousali.e. hypervigilance.
In addition to the effectiveness shown in the studies, the new medicine also gave positive results compared to theinteraction with other drugs and in subjects with comorbidities (for example hepatic insufficiency) – continues Ferini-Strambi -. Furthermore it can also be used by those suffering from sleep apnea
. This is important, because 50% of those with sleep apnea and often the therapies are contraindicated because they can delay the respiratory recovery after an apnea, reducing the amount of oxygen available. Now phase 4 will begin for daridorexant, the post-marketing one, in which the effects of prolonged use will be studied. However, studies have shown that the treatment can be continued for up to a year without problems.
In short, those who sleep badly (and little) can be treated, insomnia is not a curse. Especially not necessarily chronic. It can last several months, but a solution exists – underlines the expert -. important learn to reduce its negative impact: Cognitive-behavioral therapy has excellent results and should always be considered in the treatment of this disorder.
February 7, 2023 (change February 7, 2023 | 16:41)
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