Daridorexant - treatment for insomnia

Binkie4 said:
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."
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That's interesting. I've never asked for help with sleeplessness since I was prescribed various types of sleeping pills decades ago. They knocked me out well enough, but that isn't the same as sleeping. I decided that getting used to living with it was preferable to a rubber cosh.

But I'd be really interested in anything that promotes actual sleep, as opposed to not-awake-ness. I had Covid a couple of times recently, and the proper sleep it brought reminded me how much difference this makes to my level of function.
 
Kitty said:
That's interesting. I've never asked for help with sleeplessness since I was prescribed various types of sleeping pills decades ago. They knocked me out well enough, but that isn't the same as sleeping. I decided that getting used to living with it was preferable to a rubber cosh.

But I'd be really interested in anything that promotes actual sleep, as opposed to not-awake-ness. I had Covid a couple of times recently, and the proper sleep it brought reminded me how much difference this makes to my level of function.
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Well summarised my experience also. Sedation is not sleep
 
Binkie4 said:
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
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How do you know that it’s well suited to ME?
 
This is probably just a weird coincidence, but I thought the name Daridorexant sounded like a brand name for a new anti-perspirant. And having done a web search for it the shopping options at the top of the page were all for anti-perspirants.

I'm curious how the trade name for the stuff - Quviviq - is supposed to be pronounced.
 
Yes. How you feel about trying it (and aripiprazole) depends on a lot of things I suppose. Age, severity are two. I doubt there will be a treatment in my lifetime so it's a question of making judgements. I would really value even a bit of improvement, perhaps for a time. The threads on here about abilify are interesting.

My sleep is appalling and deteriorating. I would try daridorexant ( I think) if I could get it prescribed but local formulary is not approving it. Privately is hugely expensive. Oddly if I moved a few miles to SELondon, it could be prescribed on NHS. You obviously have some. Is it available where you are? I am hoping that my area is just behind and will decide to approve it. I need to get an appointment to discuss with GP.
 
Arnie Pye said:
This is probably just a weird coincidence, but I thought the name Daridorexant sounded like a brand name for a new anti-perspirant. And having done a web search for it the shopping options at the top of the page were all for anti-perspirants.

I'm curious how the trade name for the stuff - Quviviq - is supposed to be pronounced.
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Oh yeah I keep accidentally referring to it as deodorexant
 
Binkie4 said:
Yes. How you feel about trying it (and aripiprazole) depends on a lot of things I suppose. Age, severity are two. I doubt there will be a treatment in my lifetime so it's a question of making judgements. I would really value even a bit of improvement, perhaps for a time. The threads on here about abilify are interesting.

My sleep is appalling and deteriorating. I would try daridorexant ( I think) if I could get it prescribed but local formulary is not approving it. Privately is hugely expensive. Oddly if I moved a few miles to SELondon, it could be prescribed on NHS. You obviously have some. Is it available where you are? I am hoping that my area is just behind and will decide to approve it. I need to get an appointment to discuss with GP.
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I got private prescription from Dr Bansal but it is expensive to get privately
 
Dr Bansal wrote in his letter “I am certain this will be ideal for Sarah”. There’s a little bitch part of me that wants this to *not* work out, because I have gottten so fed up of his “certainty” over the years.
 
Sarah94 said:
Dr Bansal wrote in his letter “I am certain this will be ideal for Sarah”. There’s a little bitch part of me that wants this to *not* work out, because I have gottten so fed up of his “certainty” over the years.
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:laugh:

But the certainty pays off often enough to keep you coming back for more?
 
Sarah94 said:
Well I have taken it for tonight so I’ll try to remember to let you know tomorrow how it goes
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Please do. I'll probably be awake all night wondering how you are getting on with it........for 3 out of the last 4 nights , I haven't slept till after 5 or 6 am so I'll have plenty of time to think. If you're titrating up , maybe there will be a delay in getting full effect?

Sarah94 said:
Dr Bansal wrote in his letter “I am certain this will be ideal for Sarah”. There’s a little bitch part of me that wants this to *not* work out, because I have gottten so fed up of his “certainty” over the years.
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I think he's just positive with his patients.
He has been really helpful for me over time eg in getting hospital to do tests with saline, to go gently on exercise while in hospital, to know what was happening when I suddenly had an anaphylaxis. Also am very grateful for his NHS clinic in 2009 where GET wasn't offered.

Good luck for tonight.
 
NICE Guidance prescribing information here:

https://bnf.nice.org.uk/drugs/daridorexant/


It's quite expensive for the NHS:

https://bnf.nice.org.uk/drugs/daridorexant/medicinal-forms/

£42 for 30 tablets.


https://bnf.nice.org.uk/drugs/daridorexant/#cautions

(...)

Prescribing and dispensing information For daridorexant

Treatment duration should be as short as possible; the need for continued treatment should be assessed within 3 months of starting daridorexant and periodically thereafter.


There are 192 Interactions listed:

https://bnf.nice.org.uk/interactions/daridorexant/


Patient Information Leaflet:

https://www.medicines.org.uk/emc/files/pil.15359.pdf



https://www.nice.org.uk/guidance/ta922

Daridorexant for treating long-term insomnia

Technology appraisal guidance [TA922] Published: 18 October 2023

In PDF format:

https://www.nice.org.uk/guidance/ta...treating-longterm-insomnia-pdf-82615544244421
 
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There seems to be variation in whether this drug will be prescribed on the NHS depending on where you live.

Different Formularies are currently taking different views. e,g, SE London will prescribe on NHS while SW London won't!
 
Quite a lot here about potential side effects (provides far more information than the Patient Information Leaflet I posted above).


https://www.medicalnewstoday.com/articles/drugs-quviviq-side-effects#faq

Quviviq side effects: What you should know

--------------------------

NHS Dorset supports prescribing:

"Daridorexant is an option for patients who are eligible for it within the NICE TA who have either tried CBTi or CBTi has failed or is unavailable."

DORSET MEDICINES ADVISORY GROUP COMMISSIONING STATEMENT ON DARIDOREXANT FOR TREATING INSOMNIA DISORDER

https://nhsdorset.nhs.uk/Downloads/.../Commissioning Statement for Daridorexant.pdf


Also says re cost to NHS: "The list price for the 50‑mg or the 25‑mg dose is £1.40 per day (£42 per pack of 30 tablets; company submission)."


Which makes it considerably more expensive than, for example, amitriptyline, mirtazapine or gabapentin prescribed for sleep disturbance.
 
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