Suvorexant Associated With Lower Delirium Rates in Some Hospitalized Older Adults
Suvorexant, a sleep-promoting orexin receptor antagonist, was associated with lower rates of delirium than placebo in hospitalized older adults at high risk of delirium, but the difference was not statistically significant. Researchers published their findings in JAMA Network Open.
“Insomnia is a facilitating factor of delirium; consequently, there has been interest in the potential use of sleep-promoting medications for delirium prevention,” wrote corresponding author Kotaro Hatta, MD, PhD, of Juntendo University Nerima Hospital, Tokyo, Japan, and study coauthors.
The double-blind, phase 3, randomized controlled trial included 203 patients aged 65 to 90 years hospitalized for acute disease or elective surgery who were at high risk of delirium. Among them, 101 received 15-mg suvorexant and 102 received placebo at bedtime for up to 7 days during hospitalization.
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According to the study, delirium occurred in 16.8% of patients treated with suvorexant and 26.5% who received placebo.
By subtype, delirium with a hyperactive component occurred in 10.9% of patients treated with suvorexant and 21.6% with placebo, suggesting a benefit with suvorexant for hyperactive delirium. Delirium with a hypoactive component occurred in 5.9% treated with suvorexant and 4.9% with placebo, the study found, suggesting a lack of treatment effect.
Adverse events were generally similar between treatment groups.
“Further studies are needed to determine whether suvorexant may be useful for reducing delirium—particularly delirium with a hyperactive component—in this population,” researchers wrote.
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