From the Research
Suvorexant is the most appropriate orexin antagonist for treating addictions, particularly for stimulant and alcohol addictions, due to its ability to block both OX1 and OX2 receptors and reduce cravings and drug-seeking behaviors. This dual orexin receptor antagonist (DORA) works by dampening the brain's reward system response to drugs and reducing stress-induced relapse triggers 1. Typical dosing for addiction treatment is being investigated in the range of 10-40 mg taken orally once daily at bedtime. While primarily FDA-approved for insomnia, emerging research suggests suvorexant may help reduce cravings and drug-seeking behaviors particularly for stimulant and alcohol addictions 2, 1.
Some key points to consider when using suvorexant for addiction treatment include:
- The medication may cause side effects such as somnolence, headache, and abnormal dreams 3, 4
- Treatment duration would likely follow addiction treatment protocols of several months with regular monitoring
- Patients with respiratory disorders should use caution as orexin antagonists can potentially worsen sleep-related breathing problems
- Other orexin antagonists like lemborexant show promise but have less research specifically for addiction applications
It's essential to note that suvorexant has demonstrated abuse potential, although its overall abuse liability may be lower than zolpidem 3. However, the actual abuse rates will be assessed with postmarketing experience. Overall, suvorexant is a promising treatment option for addictions, particularly when used in conjunction with other therapies and under close medical supervision.