Can New Sleep Medication Get Out the “Foggy” Side Effects?

Sleep physicians who recommend the pharmaceutical route to better slumber must always take side effects into account. The tradeoffs are usually worth it, but what if the tell-tale fogginess could be eliminated?

A Los Angeles Times article by Melissa Healy reports that an investigational drug that works on certain receptors in the brain, particularly the lateral hypothalamus where molecules called orexins are released, could help. The medication, dubbed DORA-22, is unlike existing hypnotic sedatives that “work on so-called GABA receptors, which are found throughout the brain. That makes them a relative blunderbuss in inducing sleep and often results in residual effects.”

Those residual effects prompted the FDA recently to order changes to the recommended dosing of Ambien, particularly for women and the elderly, among whom lingering cognitive effects have proved to be common.

The study (Read Abstract Here) “Orexin Receptor Antagonists Differ from Standard Sleep Drugs by Promoting Sleep at Doses that do not Disrupt Cognition” released this week in the journal Science Translational Medicine, demonstrated effectiveness in inducing sleep in rats and rhesus monkeys. “The researchers showed that the minimum effective dose of DORA-22 to induce sleep had no effect on the animals’ [lab animals]attention and memory performance after it was administered,” writes Healy. “In the case of the widely marketed hypnotics, the minimal dose to induce sleep also resulted in cognitive deficits.”

The drug’s originator, Merck, is asking the Food and Drug Administration to consider approval of a proposed sleep medication, called suvorexant, with a similar mechanism of action to that of the DORA-22 medication.

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