Dual orexin receptor antagonists for insomnia in youth with neurodevelopmental disorders: a case series and review
| Autor: | Aaron D Besterman, Shafali S Jeste |
|---|---|
| Rok vydání: | 2023 |
| Předmět: |
Bioinformatics
Doras Sleep Initiation and Maintenance Disorders Developmental and Educational Psychology Psychology Child Pediatric education.field_of_study Dual orexin receptor antagonists biology Neurodevelopmental disorders General Medicine Sleep disorders Psychiatry and Mental health Mental Health 5.1 Pharmaceuticals 6.1 Pharmaceuticals Orexin Receptor Antagonists Sleep onset Development of treatments and therapeutic interventions Sleep Research medicine.drug Insomnia Combination therapy Adolescent Intellectual and Developmental Disabilities (IDD) Population Clinical Trials and Supportive Activities Clinical Sciences Developmental & Child Psychology Clinical Research mental disorders Behavioral and Social Science medicine Humans education business.industry Research Suvorexant Neurosciences Trazodone Evaluation of treatments and therapeutic interventions biology.organism_classification medicine.disease Comorbidity Orexin Brain Disorders Pediatrics Perinatology and Child Health business Sleep |
| Zdroj: | European child & adolescent psychiatry, vol 32, iss 3 |
| Popis: | Insomnia is a common, impairing, and difficult-to-treat comorbidity in children with neurodevelopmental disorders (NDDs). Behavioral interventions can be challenging because of developmental and behavioral features that interfere with treatment. Medication management also can be difficult due to a high burden of side effects, a high rate of paradoxical responses, and frequent treatment resistance. Therefore, new treatment options for insomnia in children with NDDs are needed. Dual orexin receptor antagonists (DORAs) are a relatively new class of pharmacotherapeutics that induce sleep by inhibiting the orexin signaling pathway. To date, there is little safety or efficacy data on the use of DORAs in children with NDDs. We present four patients with NDDs and insomnia that we treated with the DORA, suvorexant. We found that patients had a wide range of responses, with one patient displaying a robust improvement in sleep onset and maintenance, while another had significant improvement in insomnia symptoms on combination therapy with trazodone. Our final two patients had mild or no benefit from suvorexant therapy. Further research is necessary to establish the safety and efficacy of DORAs in this population and to identify predictive factors, such as specific neurogenetic diagnoses or clinical features, of a positive treatment response. |
| Databáze: | OpenAIRE |
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