From the Guidelines
Belsomra (suvorexant) does not help Alzheimer's disease itself, as it is primarily approved for treating insomnia in adults, including those with Alzheimer's disease who may experience sleep disturbances. While sleep problems are common in Alzheimer's patients and addressing them may improve quality of life and potentially reduce some behavioral symptoms, Belsomra does not treat the underlying neurodegenerative process of Alzheimer's disease or improve cognitive function, as noted in recent guidelines and reviews on dementia management 1. The medication works by blocking orexin receptors in the brain, which helps regulate the sleep-wake cycle.
For Alzheimer's patients with insomnia, typical dosing starts at 5-10 mg taken once nightly within 30 minutes of bedtime, with a maximum dose of 20 mg. Side effects may include drowsiness the next day, headache, abnormal dreams, and dry mouth. Patients should be cautious about activities requiring alertness until they know how the medication affects them, and should inform their doctor about all other medications they take to avoid potential interactions. It's also important to note that current guidelines for Alzheimer's disease treatment focus on medications like cholinesterase inhibitors and memantine, which have been shown to provide modest benefits in cognitive function and symptom management 1.
Key points to consider when treating Alzheimer's patients with insomnia include:
- Belsomra is not a treatment for Alzheimer's disease itself
- It can help with sleep disturbances, which are common in Alzheimer's patients
- The medication should be used with caution and under medical supervision
- Patients should be monitored for potential side effects and interactions with other medications
- Current guidelines prioritize other medications for Alzheimer's disease treatment, such as cholinesterase inhibitors and memantine, as noted in recent reviews and guidelines 1.
From the FDA Drug Label
In a 4-week insomnia study of BELSOMRA in 285 patients (BELSOMRA n=142; placebo n=143) with mild to moderate Alzheimer's Disease, the adverse reactions occurring ≥2% and greater than placebo were somnolence (4% compared to 1% for placebo), dry mouth (2% compared to 1% for placebo), and falls (2% compared to 0% for placebo) Patients treated with BELSOMRA exhibited a statistically significant improvement for both Total Sleep Time (TST) and Wake After Sleep Onset (WASO) measures, compared to those treated with placebo, as assessed by polysomnography at Week 4.
Belsomra (suvorexant) helps improve sleep in patients with mild to moderate Alzheimer's disease. It has been shown to improve Total Sleep Time (TST) and Wake After Sleep Onset (WASO) measures in these patients. However, it is essential to note that Belsomra is not a treatment for Alzheimer's disease itself, but rather for insomnia associated with the condition. The most common adverse reactions in patients with Alzheimer's disease taking Belsomra were somnolence, dry mouth, and falls 2.
From the Research
Belsomra and Alzheimer's Disease
- Belsomra (suvorexant) is an orexin receptor antagonist used for the treatment of insomnia.
- There is evidence to suggest that suvorexant can help improve sleep in patients with Alzheimer's disease dementia and insomnia, as shown in a randomized trial 3.
- The study found that suvorexant improved total sleep time (TST) in patients with probable Alzheimer's disease dementia and insomnia, with a model-based least squares mean improvement-from-baseline in TST of 73 minutes for suvorexant and 45 minutes for placebo.
- However, it is essential to note that suvorexant does not directly treat Alzheimer's disease, but rather addresses a common symptom associated with the condition, which is insomnia.
Current Treatments for Alzheimer's Disease
- Current approved treatments for Alzheimer's disease include cholinesterase inhibitors and N-methyl D-aspartate (NMDA) receptor antagonists, which can help manage symptoms but do not cure or prevent the disease 4, 5, 6, 7.
- Researchers are exploring new treatment strategies, including disease-modifying therapeutics, tau-targeting therapies, and immunotherapies, to address the underlying causes of Alzheimer's disease 6, 7.
- While Belsomra may help alleviate insomnia in patients with Alzheimer's disease, it is not a treatment for the disease itself, and patients should consult their healthcare provider for appropriate management of their condition.