Concomitant Use of Suvorexant With Benzodiazepines or Nonbenzodiazepines / 日本農村医学会雑誌

ABSTRACT

There have been few reports on suvorexant (SUV), a benzodiazepine-agonist hypnotic, used concomitantly with benzodiazepines (BZDs) or non-benzodiazepines (non-BZDs). Therefore, we investigated the use of SUV in patients taking BZDs and non-BZDs. Subjects were 73 individuals who were prescribed SUV while taking either BZDs or non-BZDs for 4 weeks or more from November 2015 to the end of March 2017. Subjects were divided into three groups as follows those with no weight change compared to baseline (the non-weight loss group (n = 32)), those with some weight loss (the weight loss group n = 23)), and those who discontinued the drugs (the withdrawal group (n = 18)). Age, sex, presence or absence of antipsychotic medication, continuation rate of SUV in each week after 4 weeks, and diazepam equivalent value before and after SUV administration were compared in each group. In addition, we investigated the occurrence of side effects after SUV initiation. When comparing the SUV continuation rate at 24 weeks in each group, no significant difference was found between the 3 groups, but at 8 weeks, the weight loss group showed significantly decreased rates compared to the non-weight-loss group. When diazepam conversion values were compared before and after BZD and non-BZD administration, significant differences were found in the non-weight-loss group, weight-loss group, and withdrawal group before administration. Side effects were 18.8％ in the non-weightloss group, 13.0％ in the weight loss group, and 16.7％ in the withdrawal group; 6.3％, 8.6％, and 16.7％ were in the central nervous system. It was thought that continuation rate might fall by concomitant use of SUV with BZDs or non-BZDs. For patients using SUV when taking BZDs or non-BZDs, it is desirable not only to reduce or stop the BZDs or non-BZDs, but also to be aware of withdrawal symptoms. This is because side effects may increase following discontinuation. Despite causing weight reduction, it is also important to consider improved safety.