From the Guidelines
Dayvigo (lemborexant) is likely a better option than clonazepam for patients concerned about cognitive effects, as it typically causes less cognitive impairment. When considering the cognitive effects of Dayvigo and clonazepam, it's essential to weigh the potential risks and benefits of each medication. Dayvigo, a sleep medication that works on orexin receptors, may cause some morning grogginess, memory issues, or attention problems, particularly at higher doses (10mg versus 5mg), but these effects are usually mild and diminish with continued use 1. In contrast, clonazepam, a benzodiazepine, often causes more significant cognitive impairment, including memory problems, reduced attention, slowed thinking, and impaired coordination, which can persist during daytime hours and may worsen with long-term use 1. The cognitive effects of both medications are more pronounced in older adults. Some key points to consider when evaluating these medications include:
- The potential for cognitive impairment with both Dayvigo and clonazepam
- The differences in the severity and duration of cognitive effects between the two medications
- The importance of taking the lowest effective dose and using the medication for the shortest necessary duration to minimize cognitive side effects
- The need to discuss any concerns about cognitive effects with a healthcare provider, rather than stopping the medication suddenly. It's also worth noting that clonazepam is listed on the American Geriatrics Society Beers Criteria list of potentially inappropriate medications in older adults, which may further support the use of Dayvigo as a preferred option in this population 1.
From the FDA Drug Label
Clonazepam tablets can make you sleepy or dizzy and can slow your thinking and motor skills. Interference with Cognitive and Motor Performance: Since clonazepam produces CNS depression, patients receiving this drug should be cautioned against engaging in hazardous occupations requiring mental alertness, such as operating machinery or driving a motor vehicle Tolerance to the therapeutic effect of clonazepam may develop; however, little tolerance develops to the amnestic reactions and other cognitive impairments caused by benzodiazepines
Cognition Effects of Clonazepam:
- Clonazepam can cause cognitive impairment, including slowed thinking and motor skills.
- The drug can also cause amnestic reactions, which are memory problems.
- Tolerance to the therapeutic effects of clonazepam may develop, but little tolerance develops to the cognitive impairments.
- There is no information about Dayvigo in the provided drug labels, so its cognition effects cannot be determined from this data 2, 2, 2.
- Key Points:
- Clonazepam can impair cognitive function.
- Clonazepam can cause memory problems.
- Tolerance to cognitive impairments may not develop.
From the Research
Dayvigo and Clonazepam Cognition Effects
- There are no direct studies comparing the cognition effects of Dayvigo and clonazepam in the provided evidence.
- However, it is known that clonazepam is a benzodiazepine, and benzodiazepines have been shown to have negative cognitive effects, particularly with long-term use 3.
- Studies have found that long-term treatment with benzodiazepines can cause impairment in several cognitive domains, such as visuospatial ability, speed of processing, and verbal learning 3.
- Cognitive Behavioral Therapy for Insomnia (CBT-i) has been shown to be an effective treatment for insomnia, with no negative cognitive effects 4, 5, 6, 7.
- CBT-i has been recommended as a first-line treatment for chronic insomnia, and it can produce results equivalent to sleep medication, with no side effects and fewer episodes of relapse 4, 5.