Opinion
Video
Author(s):
A panelist discusses how dual orexin receptor antagonists (DORAs) are ideal for patients with chronic insomnia who require long-term sleep support, emphasizing their safety, tolerability, and effectiveness, while cautioning against use in patients with narcolepsy, parasomnia history, or severe kidney or liver disease.
The best candidates for daridorexant, a dual orexin receptor antagonist, are individuals who suffer from chronic insomnia and require nightly sleep aids due to their persistent sleep issues. When considering this treatment, the age of the patient and any underlying comorbidities play a significant role in the decision-making process. Chronic insomnia patients who need long-term sleep support, with a focus on safety and tolerability, are ideal candidates for this medication.
However, daridorexant is not suitable for all patients. Specifically, those with narcolepsy should not be prescribed this medication, as it blocks orexin receptors, and orexin is already deficient in individuals with narcolepsy. This could exacerbate symptoms, including excessive sleepiness or even cataplexy, a condition involving loss of muscle tone triggered by strong emotions. Additionally, caution is needed when prescribing daridorexant to patients with chronic kidney or liver disease due to potential complications.
For patients with chronic insomnia, especially those complaining of daytime sleepiness, daridorexant is considered a preferable option. The medication provides an effective solution to help manage sleep and minimize adverse effects such as daytime sleepiness. If patients have concerns related to parasomnia or memory issues, daridorexant remains a strong candidate compared to other sleep aids. Working with patients to address their sleep challenges while providing a safer and well-tolerated treatment is crucial for effective management of chronic insomnia.
Keep your finger on the pulse of neurology—subscribe to NeurologyLive for expert interviews, new data, and breakthrough treatment updates.