Abstract |
Sleep disorders are common in the elderly population. Orexin receptor antagonism has been proposed as a new sleep-enabling approach to treat insomnia. The tolerability, pharmacokinetics, and pharmacodynamics of ascending single doses of almorexant, a dual orexin receptor antagonist, were investigated in healthy elderly male and female subjects. In this double-blind, placebo- and active-controlled study, each dose (100, 200, and 400 mg) was investigated in a separate group of 12 subjects ( almorexant, placebo, and zolpidem 10 mg in an 8:2:2 ratio). Morning doses of almorexant were well tolerated. As expected for sleep-enabling compounds, somnolence and fatigue were frequently reported. Other adverse events included headache and nausea. Muscular weakness was reported at a higher incidence only with the highest almorexant dose. The pharmacokinetic profile of almorexant was characterized by a median time to the maximum concentration of 1.5 hours, quick disposition with a distribution half-life of 1.6 hours, and rapidly decreasing concentrations to approximately 20% of the maximum concentration over 8 hours, with a terminal half-life of 32 hours. Objective pharmacodynamic measures showed decreases in saccadic peak velocity and adaptive tracking performance and increases in body sway with the 400-mg dose of almorexant. Subjective assessments revealed a dose-dependent decrease in alertness. Almorexant had no effects on mood, calmness, subjective internal and external perception, and feeling high. These findings provide a solid basis to study the effects of almorexant in elderly patients with insomnia.
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Authors | Petra Hoever, Justin Hay, Mandana Rad, Marzia Cavallaro, Joop M van Gerven, Jasper Dingemanse |
Journal | Journal of clinical psychopharmacology
(J Clin Psychopharmacol)
Vol. 33
Issue 3
Pg. 363-70
(Jun 2013)
ISSN: 1533-712X [Electronic] United States |
PMID | 23609389
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Acetamides
- Isoquinolines
- Orexin Receptors
- Pyridines
- Receptors, G-Protein-Coupled
- Receptors, Neuropeptide
- Zolpidem
- almorexant
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Topics |
- Acetamides
(administration & dosage, adverse effects, pharmacokinetics)
- Aged
- Aged, 80 and over
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Administration Schedule
- Female
- Half-Life
- Humans
- Isoquinolines
(administration & dosage, adverse effects, pharmacokinetics)
- Male
- Middle Aged
- Orexin Receptors
- Pyridines
(adverse effects, pharmacokinetics, pharmacology)
- Receptors, G-Protein-Coupled
(antagonists & inhibitors)
- Receptors, Neuropeptide
(antagonists & inhibitors)
- Sleep Initiation and Maintenance Disorders
(drug therapy)
- Zolpidem
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