Sunosi for excessive daytime sleepiness: 4 things you should know


Sleep Treatments | Sleep Review

Medscape: Solriamfetol (Sunosi) is a double-acting dopamine and norepinephrine reuptake inhibitor used to treat prolonged daytime sleepiness in adults.

1. Sunosi improves alertness in people with obstructive sleep apnea (OSA) and narcolepsy: One clinical study found that people who took Sunosi stayed awake longer and were less sleepy during the day than people who took placebo. A 12-week study found that 89.7% of patients with OSA who took Sunosi 150 mg had an overall improvement in symptoms at the end of the study, compared with 49.1% of those who took placebo.

2. Don’t confuse Sunosi with caffeine in a pill: Some people may consider Sunosi to be caffeine in pill form because of its waking abilities, but there are a few differences. The active substance in Sunosi, solriamfetol, is thought to promote alertness by increasing levels of dopamine and norepinephrine – chemicals that play an important role in the sleep-wake cycle – in the brain. This is different from a stimulant that releases monoamines directly. The FDA recommends taking Sunosi once a day and not within 9 hours of bedtime to avoid insomnia.

3. Sunosi does not treat underlying sleep disorders: Although Sunosi is indicated as a treatment for EDS, which is a common symptom of OSA, it does not treat the underlying cause of the disease.

4. Sunosi is a controlled substance .: Sunosi is a Schedule IV controlled substance because the drug’s active ingredient solriamfetol has the potential for abuse. A 2018 study published in the Journal of Psychopharmacology compared Sunosi with a placebo and phentermine, a weight loss promotion drug that is likely to promote alertness as it is a stimulant. Researchers found that “general drug use the next day,” a measure used in studies of drug abuse potential, was significantly higher with solriamfetol than with placebo or phentermine. They also found that participants’ willingness to take solriamfetol was significantly higher than their willingness to take placebo, but significantly less than that of phentermine.

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