The majority of older patients with insomnia are able to successfully transition to lemborexant regardless of a history of intermittent or frequent use of zolpidem, according to an open-label pilot study presented in a poster at the virtual 2021 annual meeting of the American Association for Geriatric Psychiatry.
“While this is a pilot study, the results suggest that switching to a sleeping agent that has a different mechanism of action, such as a dual orexin receptor antagonist, can be done for some insomnia patients,” said lead author Russell Rosenberg, PhD, DABSM, founder and director of the Atlanta School of Sleep Medicine and Technology, Georgia.
Researchers at Neurotrials Research, Inc., Atlanta, Georgia, studied 30 subjects aged 60 years or older who had a diagnosis of insomnia disorder based on the Diagnostic and Statistical Manual of Mental Disorders-5. Participants also spent at least 7 hours in bed per night on average and used zolpidem at least 3 nights per week.
The study consisted of a 3-week screening period during which subjects continued zolpidem treatment, a 2-week open-label titration period, a 12-week extension period, and a 4-week follow-up period. During the screening period, participants reported their sleep complaints: waking up too early (63.3%), difficulty staying asleep (30%), and difficulty falling asleep (6.7%).
Of the 30 subjects, 23 (76.7%) transitioned to lemborexant 5 mg or 10 mg after the titration period. All 23 chose to enter the extension phase, and 22 completed the study.
“Many patients experience an inability to initiate and/or maintain sleep satisfactorily and suffer the consequences of insomnia. No single prescription sleeping pill will work for all insomniacs. It very useful to have additional knowledge and options available to healthcare professionals to help treat this common sleep-wake disorder,” said Dr. Rosenberg who is also the chief executive officer of Neurotrials Research, Inc.
The study was supported by Eisai, Inc., the maker of lemborexant.
Rosenberg R, Amchin J, Kumar D, et al. A multicenter open-label pilot study evaluating next-dose transition from zolpidem to lemborexant: subgroup analysis of older adults. Poster presented at the American Association for Geriatric Psychiatry 2021 Annual Meeting; March 15-19, 2021; Virtual.