From the Guidelines
Dayvigo can cause physical dependence with long-term use, and it is crucial to use it at the lowest effective dose and for the shortest duration necessary to minimize this risk. This prescription sleep medication belongs to the orexin receptor antagonist class and works by blocking orexin, a brain chemical that promotes wakefulness. When taken regularly, especially at higher doses or for extended periods beyond the recommended treatment duration, the body may adapt to its presence, potentially leading to withdrawal symptoms if stopped abruptly. These withdrawal symptoms can include rebound insomnia (worse sleep than before treatment), anxiety, irritability, and general discomfort. The risk of dependence increases with longer use, higher doses, and in patients with a history of substance abuse. Although the study by 1 focuses on medicines associated with dependence or withdrawal, including the identification of risk factors and optimal treatment regimens, it does not specifically address Dayvigo. However, based on the general principles of managing medications with potential for dependence, as discussed in the study, it is essential to approach Dayvigo with caution. To minimize dependence risk, Dayvigo should be taken at the lowest effective dose (typically 5-10 mg once daily at bedtime) for the shortest duration necessary to manage insomnia. Patients should never stop taking Dayvigo suddenly but instead work with their healthcare provider to gradually taper off the medication when discontinuing treatment. Key considerations include:
- Using the lowest effective dose
- Limiting the duration of treatment
- Gradually tapering off the medication when discontinuing
- Monitoring for signs of dependence or withdrawal
- Considering alternative treatments for patients at high risk of dependence.
From the Research
Dayvigo Dependence
- Dayvigo, also known as lemborexant, has been studied for its potential to cause dependence in patients with insomnia disorder.
- According to a study published in 2021, lemborexant has a low dependence potential 2.
- Another study from 2021 found that lemborexant is effective and well-tolerated for the treatment of insomnia, with minimal residual effects on morning alertness or next-day function 3.
- A phase 3 randomized clinical trial published in 2021 reported that lemborexant had significant benefits on sleep onset and sleep maintenance, with no evidence of rebound insomnia or withdrawal after treatment discontinuation 4.
- A study published in 2024 found that lemborexant was effective and well-tolerated in adults aged 65 years and older with insomnia disorder, with improvements in sleep parameters and no rebound after drug withdrawal 5.
- It's worth noting that suvorexant, another dual orexin receptor antagonist, has been associated with some adverse effects, but there is no direct evidence on Dayvigo's dependence potential from this study 6.