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Efficacy and safety of lemborexant as an alternative drug for patients with insomnia taking gamma‐aminobutyric acid–benzodiazepine receptor agonists or suvorexant.

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Title: Efficacy and safety of lemborexant as an alternative drug for patients with insomnia taking gamma‐aminobutyric acid–benzodiazepine receptor agonists or suvorexant.
Authors: Okino, Kazumaro (AUTHOR), Suzuki, Hirohisa (AUTHOR), Tomioka, Hiroi (AUTHOR), Sanada, Kenji (AUTHOR), Kawai, Keita (AUTHOR), Iwanami, Akira (AUTHOR), Inamoto, Atsuko (AUTHOR)
Source: Human Psychopharmacology: Clinical & Experimental. May2023, Vol. 38 Issue 3, p1-11. 11p.
Subjects: Benzodiazepine receptors, Insomniacs, Diazepam, Insomnia, Drugs
Abstract: Background: Although gamma‐aminobutyric acid–benzodiazepine (GABA‐BZ) receptor agonists are used to treat insomnia, their long‐term or high‐dosage use causes adverse events. Nevertheless, evidence regarding the discontinuation and replacement of GABA‐BZ receptor agonists with alternative agents is lacking. Suvorexant (SUX), an existing orexin receptor antagonist, is effective in preventing nocturnal awakening in 70%–75% of patients with insomnia. Methods: The novel dual orexin receptor antagonist lemborexant (LEM) has fewer adverse effects than GABA‐BZ receptor agonists. Therefore, in this retrospective study, we categorised patients taking GABA‐BZ receptor agonists and SUX into LEM‐treated (switched) and non‐treated (non‐switched) groups and compared their outcomes over a 12‐week period. Results: The GABA‐BZ group (N = 59) comprised 34 'switched' and 25 'non‐switched' and the SUX group (N = 14) comprised 6 'switched' and 8 'non‐switched' patients. A mixed model showed a significant diazepam equivalence reduction in patients taking GABA‐BZ receptor agonists and improved Athens Insomnia Scale score in those taking SUX. The safety and tolerability of GABA‐BZ receptor agonists and SUX were high, and no serious adverse effects were observed after switching to LEM. Conclusions: Lemborexant may be a useful alternative for long‐term GABA‐BZ receptor agonist users. For SUX, the number of cases (N = 6) was insufficient to draw definite conclusions. [ABSTRACT FROM AUTHOR]
Copyright of Human Psychopharmacology: Clinical & Experimental is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Efficacy and safety of lemborexant as an alternative drug for patients with insomnia taking gamma‐aminobutyric acid–benzodiazepine receptor agonists or suvorexant.
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  Data: <searchLink fieldCode="AR" term="%22Okino%2C+Kazumaro%22">Okino, Kazumaro</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Suzuki%2C+Hirohisa%22">Suzuki, Hirohisa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tomioka%2C+Hiroi%22">Tomioka, Hiroi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sanada%2C+Kenji%22">Sanada, Kenji</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kawai%2C+Keita%22">Kawai, Keita</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Iwanami%2C+Akira%22">Iwanami, Akira</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Inamoto%2C+Atsuko%22">Inamoto, Atsuko</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Human+Psychopharmacology%3A+Clinical+%26+Experimental%22">Human Psychopharmacology: Clinical & Experimental</searchLink>. May2023, Vol. 38 Issue 3, p1-11. 11p.
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22Benzodiazepine+receptors%22">Benzodiazepine receptors</searchLink><br /><searchLink fieldCode="DE" term="%22Insomniacs%22">Insomniacs</searchLink><br /><searchLink fieldCode="DE" term="%22Diazepam%22">Diazepam</searchLink><br /><searchLink fieldCode="DE" term="%22Insomnia%22">Insomnia</searchLink><br /><searchLink fieldCode="DE" term="%22Drugs%22">Drugs</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background: Although gamma‐aminobutyric acid–benzodiazepine (GABA‐BZ) receptor agonists are used to treat insomnia, their long‐term or high‐dosage use causes adverse events. Nevertheless, evidence regarding the discontinuation and replacement of GABA‐BZ receptor agonists with alternative agents is lacking. Suvorexant (SUX), an existing orexin receptor antagonist, is effective in preventing nocturnal awakening in 70%–75% of patients with insomnia. Methods: The novel dual orexin receptor antagonist lemborexant (LEM) has fewer adverse effects than GABA‐BZ receptor agonists. Therefore, in this retrospective study, we categorised patients taking GABA‐BZ receptor agonists and SUX into LEM‐treated (switched) and non‐treated (non‐switched) groups and compared their outcomes over a 12‐week period. Results: The GABA‐BZ group (N = 59) comprised 34 'switched' and 25 'non‐switched' and the SUX group (N = 14) comprised 6 'switched' and 8 'non‐switched' patients. A mixed model showed a significant diazepam equivalence reduction in patients taking GABA‐BZ receptor agonists and improved Athens Insomnia Scale score in those taking SUX. The safety and tolerability of GABA‐BZ receptor agonists and SUX were high, and no serious adverse effects were observed after switching to LEM. Conclusions: Lemborexant may be a useful alternative for long‐term GABA‐BZ receptor agonist users. For SUX, the number of cases (N = 6) was insufficient to draw definite conclusions. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Human Psychopharmacology: Clinical & Experimental is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1002/hup.2868
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        Text: English
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        Type: general
      – SubjectFull: Insomniacs
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      – SubjectFull: Diazepam
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      – SubjectFull: Insomnia
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      – TitleFull: Efficacy and safety of lemborexant as an alternative drug for patients with insomnia taking gamma‐aminobutyric acid–benzodiazepine receptor agonists or suvorexant.
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              M: 05
              Text: May2023
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              Y: 2023
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