Talk:Suvorexant

addiction risk

What's the addiction and abuse risk of this substance A8v (talk) 23:53, 29 October 2014 (UTC)

It's Schedule IV, which ostensibly describes its addiction risk as similar to Zolpidem or Modafinil. In practice, Zolpidem can make you giddy and is highly prone to form physical dependency (so is diphenhydramine); while both Suvorexant and Modafinil lack rewarding effects at high doses and are entirely non-addictive.

Addiction and abuse risks are generally identified by comparing drug-liking measures, hence the difference in opinion between one scientific measure (drug-liking; FDA and DEA opinions) and another (observation of withdrawal and abuse among drug abusers). For example: I like Modafinil because it improves my vision in an aesthetic way (I have a better sense of the 3D form of things, which is ... striking), and because it maximizes the efficiency of my attention system in terms of focus, motivation, and prioritization; that sort of drug-liking is fully-reasonable, but it does indicate that I'll take Modafinil because I want its effects rather than because I feel an illness. Tylenol, on the other hand, is generally not sought unless there is some form of pain: people don't "like" paracetamol.

Users on Bluelight and Reddit /r/drugs report Suvorexant in higher doses provides no notable high, instead only making them tired. Obviously Merck prefers this viewpoint, while the FDA and DEA prefer a cautious approach until a lack of addiction and abuse potential are thoroughly-demonstrated by following up with patients for the next few years.

As per the DEA's concern, I would be inclined to exceed the FDA maximum dose of 20mg to get a stronger effect on weekends, because the combination of Suvorexant 15mg and Melatonin extended release 7mg allows me to sleep well for about 2-4 hours, after which I taper off. Insomnia is crap, and sleep deprivation has all but destroyed me; I like being able to sleep, and I like feeling like I'm not dying of fatal insomnia. I'll see my psychiatrist for an opinion; raising my own dose would technically be prescription drug abuse: there's no chance of getting high, but there's an inclination to use the drug in ways inconsistent with medical instruction. --John Moser (talk) 14:18, 2 December 2016 (UTC)

Table

Extended content

Suvorexant What is this drug for? treatment of insomnia Who might consider taking it? adults who have had trouble sleeping for more than one month Who should not take it? people with narcolepsy pregnant or breastfeeding women What precautions should I take? take only before bedtime when starting use of this drug, limit doing activities which require alertness do not combine with other sleep aid medications do not combine alcohol use with this drug people with Chronic obstructive pulmonary disease should be cautious people with sleep apnea should be cautious What other choices are there? increase Sleep hygiene consider over the counter drugs like Benadryl, Nytol, or Sominex consider other prescription drugs like zolpidem, zopiclone, zaleplon, ramelteon, and temazepam

I am not a big fan of another big box. It means a lot of scrolling in mobil. This information could go on wikidata maybe? Or we should combine it into the main drugbox? We are advised per the MOS to generally write in prose. This is basically writing in point form. Doc James (talk · contribs · email) 06:47, 10 November 2015 (UTC)

The box needs to be reworked. It is best here for now. Blue Rasberry (talk) 20:13, 4 May 2016 (UTC)

Adverse effects

I added information about adverse effects from an analysis of common complaints to the US government from consumers. I am not sure if a more traditional source covers these. The source I added was from my own organization's publication -

• Carr, Teresa (5 February 2016). "FDA Fields Complaints on Sleeping Pill Suvorexant". Consumer Reports.

That source cites this

• Institute for Safe Medication Practices (13 January 2016). "New Sleep Medication, New Issues" (PDF). QuarterWatch.

Blue Rasberry (talk) 20:13, 4 May 2016 (UTC)