Daridorexant - treatment for insomnia

One of my doctors informed me today that this drug has been recently approved by NICE and is going to try me on it for my sleep issues. He said it will help when I feel too wired to get to sleep.

Other insomnia sufferers might want to consider speaking to their doctor about it.

 

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My doctor has prescribed this for me and just wondering what other peoples experiences have been like with it?

 

I’m going to try and get it soon so I’ll let you know how I get on. People online say it can take a month to work and it has some side effects like bad nightmares.

 

I had Suvorexant (Australia) which is a similar orexin antagonist and unfortunately it did not do anything for sleep. Hopefully you have a better outcome with Daridorexant.

 

One of my doctors has suggested I try it. I think my GP will need to prescribe it.


edit: there should be no difficulty should there ( apart from getting an appointment- all requests have to be in writing) since it is NICE approved and not off label?

 

Where have you read this online?

 

I don’t see why it would take a month to work - I’ve been reading up and it reaches peak plasma levels 1-2 hours after taking it, and it has an elimination half-life of 8 hours. Which to me says it’s something that works straight away. @Jonathan Edwards is that correct?

 

Regarding the nightmares, clinical trials indicate that it’s generally well tolerated. Remember people are more likely to post online about it if they had a bad experience.

 

I’m planning to try it. Just helps me to be aware of potential issues so I can plan for it. The reviews were on drugs.com. Some report it works v well, but a lot don’t. I was a lot more excited about it when it was first approved in US bc there were no bad reviews and the trials looked v good.

I would also assume some bad reviews are from people don’t quit alcohol or mix with benzos and have a reaction. You cannot drink with these meds.

 

It is conceivable that a drug that 'nudges' a circadian rhythm once a night back into giving regular sleep timing could take a month to have full effect but if it is just people online gossiping I would not give it much credence.

 

The drug is an orexin receptor antagonist, I don’t think it’s anything to do with circadian rhythms but correct me if I’m wrong!

 

I would have thought that orexin was tied fairly closely in to circadian rhythm if it is involved sleepiness and narcolepsy.

In the context of insomnia this may not be very relevant, but these control mechanisms are likely very complicated.

 

It’s designed to work not as a rescue but “over time”. It’s on the Quivivq website. So you’re meant to take it every night, not just as needed.

 

The primary endpoints were change from baseline in wake time after sleep onset (WASO) and latency to persistent sleep (LPS), measured by polysomnography, at months 1 and 3.
https://pubmed.ncbi.nlm.nih.gov/35065036/

People also report that they were sleeping better after one week, and it continued to improve over following weeks.

 

If I was cynical (who me?) I would say that is to sell a lot more drug.
And even to get patients hooked.
No mention of withdrawal state so far. If it is taken regularly I would expect some pay back possibly.

 

I guess the only way to know is to try it. Insomnia is a brutal thing and we’re all told benzos are so bad for our brains. My hope is that this one being a new pathway could improve my deep sleep and sleep quality which could improve my cognitive function overall. Crossing my fingers.

 

The NICE review of it says that it isn’t dependency-forming, which I would take to mean no withdrawal.
Agree with your first point though…

 

I take Belsomra (Suvorexant), which is in the same class as Quivivq. I take it every other night, alternating it with Trazodone since these meds work better for me if I don't take them on consecutive nights.

I haven't had any problems with Belsomra, no nightmares or next-day sedation. My sleep has improved over the past year, so I've very gradually been cutting down on both Belsomra and Trazodone, with the intention of eventually eliminating both. I've had no problems cutting down on either drug. I did tell my doctor my plan, and she was fine with it.

 

Bump?

 

My Consultant for ME ( Dr Bansal- private) has written to ask my GP to prescribe this but am not yet sure if she will.

I have great problems with sleep and am currently taking 2 NHS meds for sleep but they don't reliably work. Daridorexant is a dual orexin receptor antagonist which is well suited to ME.
Can I ask if anyone has it prescribed on NHS?


edit: just found on Nice website. "The most likely cost-effectiveness estimate is within what NICE considers an acceptable use of NHS resources. So, daridorexant is recommended for routine use in the NHS."
Anyone receiving it on NHS?
edit2: sentence omitted