A sleeping giant: Suvorexant for the treatment of alcohol use disorder?

  title={A sleeping giant: Suvorexant for the treatment of alcohol use disorder?},
  author={Erin J. Campbell and Nathan J. Marchant and Andrew J. Lawrence},
  journal={Brain Research},

Gabapentin for Post-Hospitalization Alcohol Relapse Prevention; Should Gabapentin Be Considered for FDA Approval in the Treatment of Alcohol Use Disorder?: A Case Presentation and Literature Review

A case presentation and literature review demonstrating the role of gabapentin in treating AUD and symptoms associated with alcohol withdrawal, along with its potential use in relapse prevention are discussed.

Sleep and the Pharmacotherapy of Alcohol Use Disorder: Unfortunate Bedfellows. A Systematic Review With Meta-Analysis

Overall, the currently available evidences show more sleep problems with the opioidergic drugs (especially naltrexone), while acamprosate seems to be well tolerated or even beneficial, and more research is needed to further inform the clinical practice.

Repurposing the dual orexin receptor antagonist suvorexant for the treatment of opioid use disorder: why sleep on this any longer?

Several clinical trials are currently underway to examine the efficacy of suvorexant in normalizing sleep outcomes, as well as craving, stress, and sleep indices, in OUD and other substance use disorder patients, and these studies represent an important step toward repurposing suvORExant for addiction.

Effect of suvorexant on event-related oscillations and EEG sleep in rats exposed to chronic intermittent ethanol vapor and protracted withdrawal

It is suggested that suvorexant has overall sleep-promoting effects, but it may exacerbate some aspects of sleep and EEG pathology.

Non-Opioid Treatments for Opioid Use Disorder: Rationales and Data to Date

The involvement of glutamatergic, endocannabinoid and orexin signaling systems in the development, maintenance and expression of addiction-like behaviours in animal models of opioid addiction, and as potential and novel targets to expand therapeutic options to treat OUD are explored.

Drug addiction co-morbidity with alcohol: Neurobiological insights.

Orexin modulation of stress reactivity as a novel targeted treatment for anxiety and alcohol use disorder

Theoretically, ORX antagonism is a promising pharmacological treatment for individuals with AD+AUD who display increased U-threat reactivity and engage in stress-related alcohol use; though it is argued there is growing enthusiasm for ORX treatments for various individual disorders; though the paradigm can therefore be leveraged for drug discovery.

Understanding the Role of Orexin Neuropeptides in Drug Addiction: Preclinical Studies and Translational Value

Treatments that target the orexin system may be a promising strategy to reduce drug intake, mitigate relapse vulnerability, and restore “normal” physiological functions, including feeding and sleep.

Alcohol use disorder and sleep disturbances: a feed-forward allostatic framework

Sleep pathology contributes to AUD pathology, and vice versa, possibly as a feed-forward drive to an unrecognized allostatic load that drives the addiction process.



Nalmefene for the treatment of alcohol use disorders: recent data and clinical potential

  • M. Soyka
  • Medicine
    Expert opinion on pharmacotherapy
  • 2016
Nalmefene is the first medication to be approved specifically in this indication and seems to be most suitable for patients with alcohol misuse or a rather low physical dependence on alcohol who do not require immediate detoxification or inpatient treatment.

Acamprosate in alcohol dependence: how does it work?

It is suggested that acamprosate may reduce craving that is associated with conditioned withdrawal and be a novel kind of agent that suppresses "craving" in weaned alcohol dependent patients.

Role of Lateral Hypothalamic Orexin (Hypocretin) Neurons in Alcohol Use and Abuse: Recent Advances

Recent studies have identified anatomic loci of action and interactions between OX and other neuropeptides that drive alcohol seeking, and future studies are required to fully elucidate these behaviors, in which optogenetic and chemogenetic approaches may prove useful.

Gabapentin treatment for alcohol dependence: a randomized clinical trial.

Gabapentin was effective in treating alcohol dependence and relapse-related symptoms of insomnia, dysphoria, and craving, with a favorable safety profile and increased implementation of pharmacological treatment of alcohol dependence in primary care may be a major benefit of gabapentin as a treatment option for alcohol dependence.

Alcohol Detoxification and Relapse Prevention Using Valproic Acid Versus Gabapentin in Alcohol-dependent Patients

The results of this randomized trial suggest that the anticonvulsants were not significantly better than placebo in treating mild withdrawal symptoms, did not influence relapse to alcohol and did not treat the symptoms of depression and sleep disturbance that occur in the postwithdrawal period.

Pharmacotherapy of alcoholism – an update on approved and off-label medications

This paper discusses approved AUD medications, including the opioid antagonists naltrexone and nalmefene, the putative glutamate receptor antagonist acamprosate and the aldehyde dehydrogenase inhibitor disulfiram, and off-label medications of interest, including topiramate, gabapentin, ondansetron, varenicline, baclofen, sodium oxybate and antidepressants.

Gabapentin combined with naltrexone for the treatment of alcohol dependence.

The addition of gabapentin to naltrexone improved drinking outcomes over nALTrexone alone during the first 6 weeks after cessation of drinking, and this effect did not endure after gabAPentin was discontinued.

Naltrexone in the treatment of alcohol dependence.

The findings do not support the use of naltrexone for the treatment of men with chronic, severe alcohol dependence.

The hypocretin/orexin system as a target for excessive motivation in alcohol use disorders

The role of ORX in alcohol-associated behaviors and whether and how this system could be targeted to treat alcohol use disorders while avoiding impacts on other ORX-relevant functions are focused on.