Breakthrough in Alzheimer's Research: A Common Sleeping Pill Suvorexant (Belsomra) Could Hold The Key To Prevention!

Alzheimer's Disease: In a groundbreaking discovery, researchers at Washington University School of Medicine in St. Louis have found that the common insomnia medication, suvorexant, has the potential to reduce Alzheimer's disease proteins in the brain. Although the study was small and more research is required to confirm its effectiveness, this breakthrough could have far-reaching implications for millions of people worldwide affected by Alzheimer's.


 
Sleep disturbances have long been linked to the early stages of Alzheimer's disease. In fact, many people diagnosed with the disease experience difficulty falling and staying asleep years before cognitive problems such as memory loss and confusion emerge. Alzheimer's disease disrupts sleep, and poor sleep accelerates harmful changes to the brain - creating a vicious cycle that has baffled scientists for years.
 
The groundbreaking study, suggests that the U.S. FDA-approved sleeping aid suvorexant (Belsomra) could potentially break this vicious cycle. Researchers found that participants who took the sleeping pill experienced a drop in key Alzheimer's proteins levels, indicating that sleep medications could potentially slow or stop the progression of the disease.
 
Senior author Dr Brendan Lucey, MD, an associate professor of neurology and director of Washington University's Sleep Medicine Center, cautions that the study is preliminary, and it would be premature for those concerned about developing Alzheimer's to begin taking suvorexant nightly. However, he emphasizes that the results are very encouraging, as the drug is already available, proven safe, and now shown to affect critical Alzheimer's-related protein levels.
 
He told reporters from TMN covering the Alzheimer's Disease beat, “This is a small, proof-of-concept study. It would be premature for individuals who are worried about developing Alzheimer’s to interpret it as a reason to start taking suvorexant every night. We don’t yet know whether long-term use is effective in staving off cognitive decline, and if it is, at what dose and for whom. Still, these results are very encouraging. This drug is already available and proven safe, and now we have evidence that it affects the levels of proteins that are critical for driving Alzheimer’s disease.”
 
Suvorexant, sold under the brand name Belsomra, is an orexin antagonist medication which is used in the treatment of insomnia. It is also known as a dual orexin receptor antagonists (DORA). It acts as a selective dual antagonist of the orexin OX1 and OX2 receptors. Orexin is a natural biomolecule that promotes wakefulness, and when blocked, people fall asleep.
 
Suvorexant is indicated specifically for the treatment of insomnia characterized by difficulties with sleep onset and/or maintenance in adults. Suvorexant helps with falling asleep faster, sleeping longer, being awake less in the middle of the night, and having better quality of sleep. Its effectiveness is modest, and is similar to that of other orexin antagonists, but is lower than that of benzodiazepines and Z-drugs. Suvorexant is taken by mouth.
 
Side effects of suvorexant include somnolence, da ytime sleepiness and sedation, headache, dizziness, abnormal dreams, dry mouth, and impaired next-day driving ability. Rarely, sleep paralysis, sleep-related hallucinations, complex sleep behaviors like sleepwalking, and suicidal ideation may occur. Tolerance, dependence, withdrawal, and rebound effects do not appear to occur significantly with the medication.
 
The medication has an intermediate elimination half-life of 12 hours and a time to peak of about 2 to 3 hours. Unlike benzodiazepines and Z-drugs, suvorexant does not interact with GABA receptors, instead having a distinct mechanism of action.
 
Clinical development of suvorexant began in 2006 and it was introduced for medical use in 2014. The medication is a schedule IV-controlled substance in the United States and may have a modest potential for misuse. In other places, such as Australia, suvorexant is a prescription-only medicine and is not a controlled drug. Suvorexant is not available in generic formulations. Besides suvorexant, other orexin receptor antagonists like lemborexant and daridorexant have also been introduced and approved by the U.S. FDA.
 
Alzheimer's disease is characterized by the accumulation of amyloid beta protein plaques in the brain, followed by the formation of toxic tau tangles, which lead to neuronal death and cognitive symptoms such as memory loss. Poor sleep has been linked to higher levels of both amyloid and tau in the brain, but it remains unclear whether good sleep can have the opposite effect. Mouse studies with orexin inhibitors have shown promising results.
 
In this pioneering study, 38 participants aged 45 to 65 with no cognitive impairments underwent a two-night sleep study. Participants were given either a low dose (10 mg) of suvorexant, a high dose (20 mg), or a placebo at 9 p.m. and slept in a clinical research unit at Washington University. Researchers then collected cerebrospinal fluid samples every two hours for 36 hours to measure amyloid and tau levels.
 
Significantly, the study found that amyloid levels dropped 10% to 20%, and a key form of tau known as hyperphosphorylated tau dropped 10% to 15% in participants who received the high dose of suvorexant compared to those who received the placebo. The low dose group did not show significant differences compared to the placebo group.
 
Dr Lucey is currently conducting studies to assess the long-term effects of orexin inhibitors in people at higher risk of dementia. He acknowledges that future research needs to involve chronic treatment and the measurement of amyloid and tau levels over time. The study's participants were healthy middle-aged individuals, and results may differ in an older population with existing amyloid plaques in their brains.
 
Despite the preliminary nature of the study, the findings present a hopeful possibility that the link between sleep and Alzheimer's disease could be harnessed for the prevention of cognitive decline. As researchers continue to explore the potential of sleep medications like suvorexant in combating Alzheimer's disease, the scientific community remains cautiously optimistic about the future of Alzheimer's prevention and treatment.
 
Dr Lucey emphasizes the importance of maintaining good sleep habits and seeking treatment for sleep problems, as they are currently the best ways to safeguard against the potential progression of Alzheimer's disease. The breakthrough study on suvorexant is just the first step in understanding the complex relationship between sleep and Alzheimer's, and how it can be leveraged for the benefit of millions of people.
 
As more research is conducted on the potential of suvorexant and other orexin inhibitors, there is hope that these drugs could one day become a vital tool in the fight against Alzheimer's disease. With the number of Alzheimer's cases expected to rise significantly in the coming decades, the urgency of finding effective treatments and preventive measures has never been more critical.
 
The sensational discovery that a common sleeping pill could potentially reduce Alzheimer's proteins in the brain could be the beginning of a new era in Alzheimer's research. This groundbreaking study serves as a strong foundation for future research and opens the door to exciting possibilities in the quest to prevent or slow the progression of this devastating disease.
 
The study findings were published in the peer reviewed journal: Annals of Neurology.
https://onlinelibrary.wiley.com/doi/10.1002/ana.26641
 
With the current COVID-19 pandemic wreaking havoc around the world and causing more breakthrough infections, a lot of studies are already showing that the SARS-CoV-2 virus can also contribute to the development or even acceleration of neurodegenerative disease like Dementia, Parkinson’s disease and also Alzheimer’s disease. As such, it can definitely be assumed that Alzheimer’s disease is expected to be a major burden on the global public healthcare system in coming years and there is an urgent and dire need for the research and development or identification of proper therapeutics and even prophylactics to deal with it.
 
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