Daridorexant: what is it, what is it for and its side effects

Insomnia is a widespread disorder in the general population that is fundamentally characterized by a decrease in the quality or quality of sleep, which usually causes discomfort and negatively affects the daily life of those who suffer from it. Therefore, it is important to find a good treatment for insomnia.

Daridorexant is a drug that was developed to treat insomnia, being a drug belonging to the category of “orexin receptor antagonists”. The main action of this drug is to block the mechanism of action of a substance in the brain that causes wakefulness.

In this article we will discuss in more detail what this drug against insomnia consists of and then what are the main alternative treatments to pharmacology which are usually used to treat this sleep disorder and which have no side effects.

    What is Daridorexant?

    Daridorexant is a drug that is used, under medical supervision, to treat insomnia. This drug belongs to the category of “orexin receptor antagonists”, also called hypocretin, which is an excitatory hormone of the central nervous system. The main action of this drug is to block the mechanism of action of a substance in the brain that causes wakefulness.

    It should be noted that in January 2022, Daridorexant was approved in the United States for use under medical prescription, becoming available in May of the same year. Likewise, the European Union approved this drug in April 2022, making it the first orexin receptor antagonist to be available on the European continent.

    According to some research that has been conducted regarding the use of Daridorexant, This drug produces fewer side effects than others that are usually prescribed for insomnia and also does not create addiction or tolerance, so it offers promising benefits.

    However, it is important that this drug be supervised by a doctor due to the fact that its misuse could lead to several health problems, as we will discuss in more detail shortly. Por otro lado, the daridorexant usually sold in tablets to be taken by mouth and normally it is taken once a day (about 30 minutes before going to bed). This medicine can be taken with or without food, although if taken on an empty stomach it will work faster and will not cause any harm in these cases either.

    Daridorexant normally begins to take effect in the treatment of insomnia within 7 to 10 days of starting its use. On the other hand, you should not take this medicine when you go to sleep less than 7 hours because you could become excessively drowsy and it would be dangerous if you had to drive or carry out activities requiring a certain level of alertness.

      Possible side effects of Daridorexant

      Daridorexant should only be used under prescription and under medical supervision due to the fact that it can cause certain side effects. Also there are a series of precautions to take into account before consuming it and that the specialist must know:

      • The doctor should be informed in case of an allergic reaction after taking Daridorexant.
      • You should also tell your doctor if you are allergic to any other medicine or any ingredient in Daridorexant.
      • It is important to tell the doctor if you are taking any other medications and even nutritional supplements.
      • Tell the specialist if you have narcolepsy.
      • Inform if you are pregnant.
      • Alcohol should not be consumed during treatment with Daridorexant.

      Now that we have already seen some precautions to take into account before taking Daridorexant, it is time to explain to you what it is side effects this medicine may cause:

      • Difficulty reaching a fully alert or wakeful state after sleeping through the night.
      • daytime sleepiness
      • This could cause some mental health problems, and it is important to notify the doctor in this case as soon as possible.
      • Headache or headache.
      • Nausea
      • dizziness

      There are others more serious side effects, although also less frequent, which could occur; being important in this type of case to call the doctor immediately:

      • Hallucinations on waking and/or at bedtime.
      • Weakness in the legs at night and/or throughout the day.
      • Suffer from an inability to speak and/or move for a few minutes when you fall asleep or even when you wake up.

      However, it is important to always use this medication under medical prescription and without exceeding the doses, since an overdose of this drug could lead to certain health problems, as we will see below.

        Most Common Symptoms of a Daridorexant Overdose

        When a person takes Daridorexant in high doses or above the amounts prescribed by the professional or even if it has been taken more often than it should, they may appear a series of complications associated with an overdose of this medicine, the following being the most common:

        • Excessive sleepiness.
        • fatigue
        • headache
        • Attention and concentration problems.
        • Voluntary loss of muscle control.
        • Inability to move and/or speak.
        • Constipation.
        • Muscular weakness

        It is important that each patient has written down all the medications they are takingwith and without a prescription, in order to properly inform the general practitioner or the emergency doctor in the event of a complication and thus be able to receive the most appropriate recommendations according to each particular case.

          Insomnia treatments

          To be able to make the diagnosis of insomnia, this difficulty in initiating or maintaining sleep must occur several nights a week and over a period of 3 months or more.

          The prevalence of insomnia in the world is quite remarkable, which is why it has become a very relevant health issue for different health organizations. When it comes to treating insomnia, there are different treatments, and the importance of good sleep hygiene should be noted, as discussed below.

          1. Sleep hygiene

          Good sleep hygiene can help achieve this. a decrease in those habits that could interfere with good rest, being important that they are replaced by a series of habits that facilitate sleep. The most useful tips for good sleep hygiene are:

          • Avoid or limit the consumption of stimulating drinks, such as energy drinks or coffee.
          • Try to go to bed and get up at the same time every day or as much as possible.
          • Exercise regularly but never before going to bed.
          • Do not perform tasks incompatible with rest in the bedroom.
          • Check the temperature, light or noise in the bedroom before going to bed.
          • Seek professional help if you have worries or problems that keep you from resting.
          • Do not eat large meals during dinner and do not eat dinner too late.

          2. Stimulate control

          Stimulus control is usually included in sleep hygiene or both are used in a complementary way to improve outcomes. Some of the most common recommendations to implement proper control of stimuli to be able to sleep well, these are:

          • Perform a series of routine tasks associated with lying down to sleep that facilitate falling asleep.
          • Don’t stay awake in your leg rolling over if you can’t sleep for more than 20 minutes.
          • Go to bed when you’re really sleepy.
          • Have regular times for going to bed and waking up.
          • Do not make bedroom activities that keep us awake.
          • Avoid using screens or mobile phones at least 2 hours before going to bed (it is better to read a book).

          3. Relaxation techniques

          Among the main relaxation techniques that can be used against insomnia we can emphasize the progressive relaxation (you can find manuals or articles online that explain step by step how to perform this technique). This technique has been shown to be effective as a treatment for insomnia in adults and to help with insomnia in children, although its effectiveness is less proven. Likewise, as relaxation techniques against insomnia, we can also include others such as abdominal breathing.

            4. Chronotherapy

            Chronotherapy, also known as “sleep restriction”, is usually used in combination with relaxation, sleep hygiene and stimulus control techniques because if used in isolation it is less likely good results are obtained.

            The way to achieve this technique against insomnia consists essentially in delaying bedtime until the total time spent in bed approximately matches the time you actually sleep and avoid being in bed tossing and turning when you can’t fall asleep. During this time, you can read a book in a relaxed way in another room or in another room of the house until you feel sleepy. It is also recommended to follow all previous recommendations (eg sleep hygiene).

            Bibliographic references

            • Amigo, I. (2020). Handbook of Health Psychology. Madrid: Ediciones Pyramid.
            • Buela-Casal, G. & Guillén-Riquelme, A. (2020). Sleep disorders In A. Belloch, B. Sandín & F. Ramos (coords.). Handbook of Psychopathology. Volume 1: Third edition (pp. 541-555). Madrid: McGraw Hill.
            • De Crescenzo, F. et al. (2022). “Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorders in adults: a systematic review and network meta-analysis”. Lancet., 400 (10347), p. 170–184.
            • Emmanuel, MD et al. (2022). Safety and efficacy of daridorexant in patients with insomnia disorders: results of two phase 3 multicenter, randomized, double-blind, placebo-controlled trials. The Lancet Neurology, 21(2), p. 125-139.
            • Jacobson, LH, Hoyer, D. & de Lecea, L. (2022). “Hypocretins (orexins): The ultimate translational neuropeptides”. J Intern Med., 291 (5), p. 533–556.
            • Muehlan C, Vaillant C, Zenklusen I, Kraehenbuehl S & Dingemanse J (2020). “Clinical pharmacology, efficacy and safety of orexin receptor antagonists for the treatment of insomnia disorders”. Expert Opin Drug Metab Toxicol., 16 (11), p. 1063–1078.
            • Roch, C., Bergamini, G., Steiner, MA and Clozel, M. (2021). “Nonclinical pharmacology of daridorexant: a new dual orexin receptor antagonist for the treatment of insomnia”. Psychopharmacology (Berl)., 238 (10), pp. 2693–2708.
            • Wang, L. et al. (2021). “A network meta-analysis of the long- and short-term efficacy of sleeping pills in adults and the elderly”. Neuroscience and Biobehavioral Journals., 131, pp. 489–496
            • Yves, MD (2020). Daridorexant, a novel dual orexin receptor antagonist to treat insomnia disorders. Annals of Neurology, 87(3), pp. 347-356.
            • Zammit, G. (2020). Daridorexant, a new dual orexin receptor antagonist, in elderly subjects with insomnia disorders. American Academy of Neurology, 94(21), pp. e2287.

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