From the Guidelines
There is currently no conclusive evidence that suvorexant prevents Alzheimer's disease. While some research suggests a potential link between sleep disorders and Alzheimer's disease development, and suvorexant (brand name Belsomra) is approved for treating insomnia, it has not been established as a preventive treatment for Alzheimer's 1. Suvorexant works by blocking orexin receptors in the brain, which helps regulate the sleep-wake cycle. Some preliminary studies have explored whether improving sleep quality might impact the accumulation of amyloid beta and tau proteins associated with Alzheimer's disease, but these findings remain investigational.
The standard dose of suvorexant for insomnia is 10-20mg taken once nightly before bedtime, but this medication should only be used for its FDA-approved purpose of treating insomnia under a doctor's supervision 1. If you're concerned about Alzheimer's prevention, current evidence more strongly supports lifestyle modifications like:
- Regular physical exercise
- Cognitive stimulation
- Heart-healthy diet
- Blood pressure management
- Social engagement rather than medication approaches 1. It's essential to note that suvorexant is not recommended for preventing Alzheimer's disease, and its use should be limited to treating insomnia in adults, as suggested by clinical practice guidelines 1.
From the Research
Suvorexant and Alzheimer's Disease
- Suvorexant is a dual orexin receptor antagonist that has been shown to be effective in treating insomnia in patients with Alzheimer's disease dementia 2.
- A study published in 2020 found that suvorexant improved total sleep time in patients with probable Alzheimer's disease dementia and insomnia, with a model-based least squares mean improvement of 73 minutes compared to 45 minutes for placebo 2.
- Another study published in 2023 found that suvorexant acutely decreased tau phosphorylation and amyloid-β concentrations in the central nervous system, suggesting potential as a repurposed drug for the prevention of Alzheimer's disease 3.
Mechanism of Action
- Suvorexant works by targeting orexin receptors, which are involved in the regulation of sleep and wakefulness 4.
- The drug has been shown to decrease soluble amyloid-β levels and amyloid plaques in mouse models, and to decrease tau phosphorylation in human cerebrospinal fluid 3.
Clinical Trials
- Several clinical trials have evaluated the efficacy and safety of suvorexant in patients with insomnia, including those with Alzheimer's disease dementia 2, 5, 6.
- These trials have found that suvorexant is generally well-tolerated and effective in improving sleep onset and maintenance, with some studies suggesting potential benefits for patients with Alzheimer's disease 2, 3.
Prevention of Alzheimer's Disease
- While suvorexant has shown promise in reducing tau phosphorylation and amyloid-β concentrations, it is not currently approved for the prevention of Alzheimer's disease 3.
- Further studies are needed to fully understand the potential benefits and risks of suvorexant for the prevention of Alzheimer's disease 3.