New Drug for Insomnia
The Federal Drug Administration (FDA) review committee suggested that a new type of drug for the treatment of insomnia might be approved in the future if the company who produces the drug, Merck, begins manufacturing it in smaller doses.
The drug, suvorexant, works differently from most sleep medications. Instead of creating sleepiness, it blocks a type of neurotransmitters called orexins, which are responsible for wakefulness. (Suvorexant is a selective antagonist of orexin receptors OX1R and OX2R and blocks the binding of orexin A and B to these receptors, presumably inhibiting activation of neurons of the arousal system.) The drug has a 12-hour half-life, longer than other insomnia drugs, thus morning carryover sedation is a potential problem.
The FDA asked that suvorexant be produced at the lower dose of 10mg, with the option of prescribing it at higher doses (15mg to 20mg) if a patient tolerated the 10mg dose and that dose did not sufficiently improve the patient’s insomnia. Merck had initially proposed doses of 15mg to 40mg.
