How Do Orexin Blocking Medications Treat Insomnia? (Dayvigo, Lemborexant, Belsomra, Suvorexant)
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- Опубликовано: 3 июл 2024
- This video provides a brief introduction to sleep and insomnia disorder followed by a detailed discussion on orexin and the treatment of insomnia disorder.
Time Stamps
Introduction to the topic: 00:00 to 00:49
Sleep in Psychiatry: 00:50 to 02:41
DSM-5 criteria Insomnia Disorder: 02:42 to 05:04
Types of Insomnia: 05:05 to 06:18
Epidemiology: 06:19 to 07:28
Hypocretin/Orexin: 07:29 to 10:26
Neurobiology of Orexin: 10:27 to 14:11
Why does Orexin blockade work for insomnia: 14:12 to 17:36
Suvorexant and Lemborexant: 17:37 to 20:10
Side Effects of orexin antagonists: 20:11 to 24:16
Pharmacokinetics, metabolism, absorption: 24:17 to 25:22
My take on the medication: 25:23 to 29:40
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Disclaimer: This is not medical advice, and the information is provided for educational purposes only. Please consult your doctor for any specific medical questions.
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Practical and focused review
Amazing comprehensive review 🙏🏻
Many people fall victim for benzos addiction, its good to be educated about all alternatives ( including life style modifications, non phara interventions, and at the ends safer options of treatment)
From the bottom of my heart, thank you for helping me understand this. I feel so much more prepared with this understanding of the problem, phenomenon, and root causes. You are a true professional. God bless you.
Dr. R always coming in clutch with the useful practical and balanced review of meds. Love the vids and keep it up!
Would love to see a video on Lyrica and gabapentin sometime 💪
Thank you, appreciate all the support
I was on trazodone. That was the best medication ever. it would put me to sleep in a half hour. I was able to use it for a couple of years . before it stopped working, it was in and out
I found 400mg of Magnesium Bisglycinate and 5mg of extended release Melatonin at bed time fixed my sleep issues that I had for several years.
I just graduated college and after being on Lunesta for 2 years, I finally replaced it with Dayvigo and it’s a night and day difference. No ill effects the next day, no hangover… Just a restful nights sleep.
Wow so good to hear. Im done taking Lunesta after 2 years, stopped working. Just prescribed Dayvigo, really hope it works, tired of being exhausted
Thanks Dr Rossi, love the Jersey accent :)
thanks for watching, I always appreciate the love and support here on the channel
Great video
Dr what about the newest sleep medication Quviviq? Those 2 your talking about did nothing for Mt chronic insomnia. Are you against Lunesta for long term treatment?
God Bless you
Wondering what you opinion on Daridorexant ?
Anything good? What are the differences between Suvo-Lembo-Darido? just curious.
belsomra made me feel horrible and kept me even more awake and feeling like i was dying
Insomnia must be taken a lot more seriously!
If Ur reading the could U do a video on chronic sleep disorders with fibromyalgia and chronic fatigue disorders that haven’t been resolved with cognitive therapy or any other psychiatric medications or hypnotics. Thank you
sounds like a good topic but the research may be limited in that area it's a very unique population
I have Srögrens Syndrome, Lupus and POTS and suffer from severe insomnia and have my whole teen and adult life. My Doctor wrote for Ambien in 2019 and I totaled a brand new 4 Runner I hadn’t even made the third payment on. I remember none of it. Not even the life flight to a trauma hospital in Atlanta. Soooooo thankful I did not hurt anyone else. I was single at the time and home alone. I’m married now and just recently revisited sleep meds since I have supervision incase of any crazy reactions. If you were to have asked me I would have said I slept great the night of the wreck! 😮 I’m on night 6 of Quviviq and zero issues! I am actually able to fall asleep what feels like would be naturally. I don’t feel “drunk” or that I’m not in my right mind. I wake up feeling great!! I do wake up several times to use the bathroom but easily able to fall back asleep. ❤
Will Lemborexant improve Delta sleep.
Apakah bisa untuk kecemasan dokter yg susah untuk memulai tidur
Does diet play a role in not being able to fall asleep?
You should do a video on Restoril/Temazepam
Run rast..no benzo. You been warned
That’s the only drug that has helped me sleep very well. It works very fast too sometimes in 15 mins.
What do you think of quetiapine being used for insomnia?
Careful with Quatipine , horrific side effects and major issues with high chlorestorol, high sugars, high triglycerides. Also very hard to come off of.
Yo lo probé para el insomnio terminal por 10 días. Afecta tu motivación y estado de animo. I tried Quetiapine for treating my terminal insomnia. It lengthened my sleep time but it affected my motivation. It is not a good medicarion for my insomnia disorder.
Only very minimal doses for a very short period of time, basically like any sleep medication.
Quetiapine, can also cause major weight gain, like 10-20 lbs a month. When I was on it, I had to basically cut one meal out. It might also cause gynecomastia, breast tissue growth in men.
What does it mean if I am never tired mind and body I can stay up for two days straight not fighting. I rejuvenate energy. What does this mean. I am 55. I am always hot. My body temperature is hotter than most. What should I do?. This change came about in menopause I was always able to fall asleep whenever I needed to. I am a depressed person, so this was my escape. Now I can stay up for days and nobody knows what to do. My doctor does not give opioids which is fine I understand, but this drug does not help me either I walk to get tired. I have energy that I have no idea how I have a lot of probably cortisol which I will research next. I am left behind my friends who are ordinary people who get up in the morning and sleep at night. They leave me behind. I am left behind sitting in a chair most of the time. What test can I do? Please advise..
A little bit of a theoretical question , should distress be a criteria for diagnosis? It seems like their is some basic evidence that sleep is important to cellular repair. At least in rats indefinite sleep deprivation leads to multi organ failure and death. If a person is not getting enough of a necessary process that could impact health even if thy do not have insight about it. This seems analogous to high blood pressure which most people don’t notice.
the criteria are far from perfect but they do stress this idea that the person is distressed by the insomnia. In fact someone could be sleeping 4 hours a night and not be distressed by it and thus not meet criteria for insomnia. I agree sleep is critical and I think most people are aware of the problems it's causing when the quality and or quality is poor. The main exception being those in a manic episode who have a decreased need for sleep and fail to recognize how it might be impacting the illness
I have been paying attention to dayvigo, a new type of sleeping pill, for a long time, and just saw this video today.
DO not take it!
@@Friendlyadhd10 I agree, plus Dayvgo has very very low success rateings
Quviviq is better
@@Friendlyadhd10 Why?
I have been taking 60 mg of Paxil per day I have heard the Paxil contribute to insomnia is this true I have tried to research and some things have said yes I cannot fall asleep. So what do I do?
Paxil does ñot contribute to insomnia. Just the opposite. Its the most sedating of the ssris.
Fr, what’s the list of reasons to hate benzodiazepines? I clearly need educational material to better understand what other short/long term negative effects benzodiazepines carry separate from the potential for abuse.
For me they don’t solve the problem. While they work well in the short term for the physical symptoms of anxiety most patient still experience anxious thoughts and have the same issues with or without the benzo. There is also some increased risk for dementia with prolonged use. In the short term fine, in the long term there is risk and it doesn’t get at the underlying cause of anxiety. Hope this helps if you haven’t subscribed to the channel please do and spread the word about what we are doing here
@@ShrinksInSneakers benzo are the next opio crisis...Xanax the worst med of 5gem all to wd from long term use,
@@ShrinksInSneakers Because they dont cause cancer like the new ones do, they want more cancer lol
Belsomra didn’t work for me and it caused sleep paralysis.
for me falling asleep isn’t a nightmare. because i don’t even fall asleep yo dream lol
If orexin increases appetite, would these drugs help you lose weight and get better sleep at the same time?
I know it's not a weight loss drug but if you need an insomnia medication anyway, and you are hungry at night and need to lose weight anyway, seems like this might be a good choice versus other classes of sleep medicine.
If it increases appetite, u will gain weight, not lose weight
@@donkeyballs3307 it’s an inhibitor dope
For me with DAYViGO I have no appetite..but this medicine makes me nauseous, headaches, rashes, itchiness, hot flashes (I am taking hormone pill but I get really bad hot flashes..not sure why?). It does help me to fall asleep quickly but does not help with stay in sleep. I only sleep 3 hours with 5mg. Even when I take 10mg I get up after 4 hours. Forgetful with words..but talkative. I feel like I am awake & sleepy at the same time.
I would not recommend this medicine. I feel unwell as if I have a severe cold. Some people said they have really bad nightmares.
I only took this medicine for 3nights.
Very frustrating!
Strong opioids, like 600 mlg of morphine ,that's what allows me to sleep a few hours
Unfortunate being a addict. Every dog has his day…
@@SPASPAWIZyou don't understand what debilitating insomnia is
@@Elektra_7 junky
@@Elektra_7 you don’t know what you are talking about and opiates are not the solution to long term insomnia, they are far from it. Opiates need to have their dosage raised to be effective after short periods. Regardless of dosage it takes over your body and you become dependent or addicted or both. It changes your brain and hormones. In fact long term use of opiates is proven to make insomnia worse!! So go get help and accept your problem.
Nobody said opiates don’t put you to sleep they work great for sleep. Also very relaxing. One of the worst things for long term debilitating insomnia. The insomnia probably arose from opiate use anyway.
Insomnia cant be healed with medication. The mind has to be born anew- and it takes crucial work during years sometimes.
Dr Rossi belsomra was a disappointment for me it did nothing. I still didn’t sleep but did not have any side effects. Ambien cr and Restoril still works better.
They don't!
These meds have a very very low rating for success, plus very expensive...sure helps some but generally speaking not a good option
Yup.
I'd say that they're marginally better than Benadryl or sedating antihistamines like Piriton.
I thought he was reading from a script but looked closer and... Well let's say he's just not
Quviviq hasn't done anything for me but I've only been on it a month. I heard you have to take it for a while for it to work.
Hi Nick
Sorry to hear that. I tried it a few times, didn't work. Have you tried anything else for sleep? Im not finding anything to work. Lunesta for 2 months now, doesn't always work
@@michaelthau1007 Remeron and Seroquel. I can't handle the grogginess from those. I see my sleep doctor on Monday so I'll be talking to him.
@@NickArcade brand saraquel as you knowxare not sleeping pills and saraquel has some serious side errects.. hope things are better
My Dr is recommending it for me. Did it eventually work for you, I also heard it can take up to a month. Have you felt anything at all? The sleep paralysis possible side effect scares me. Thanks
@@user-wb2yv7ll9d I actually found a way to get it to work. On a 50 mg dose I would cut the pill into halves and take it sublingually. You can do it sublingually on 50 mg but I recommend 25 mg or lower if you can get it cut further so you don't get groggy. I no longer take it due to the price