Retrospective Study of Introducing Suvorexant to Long-term Users of Benzodiazepines

Benzodiazepines (BZDs) are frequently used for insomnia, but the long-term use of BZDs is associated with adverse events such as dependence and withdrawal syndrome. Suvorexant (SUV), an orexin receptor antagonist, is a novel hyp-notic drug that has been shown to be effective for subjective measures of sleep onset and maintenance, safe, and well tolerated in clinical trials. In a long-term clinical trial, SUV discontinuation did not cause rebound insomnia or withdrawal symptoms, suggesting that it may be useful as an alternative drug in long-term users of BZDs. We retrospectively investigated the prescriptions when SUV was introduced to long-term users of BZDs. Sixty patients of long-term users of BZDs, who were prescribed SUV during January 2015 to December 2017, were analyzed. These patients were divided into the add-on group (n = 28) and the switching group (n = 32). The rate of SUV prescription continuation was 92.9 ％ in the add-on group, which was significantly higher ( P = 0.048) than 71.9 ％ in the switching group. The all adverse events rate was 32.1 ％ in the add-on group and 28.1 ％ in the switching group, and there was no significant difference between the two groups. This study revealed that in long-term users of BZDs, add-on and switching were equivalently selected as the method of introducing SUV. It was also suggested that the rate of SUV prescription continuation could be maintained higher in the add-on group than in the switching group.