This is a new guideline from Nice advising that daridorexant can be used to treat insomnia in certain situations. It was published in October 2023.
What is daridorexant?
It is an orexin receptor antagonist. It blocks the actions of orexin neuropeptides. All crystal clear? There is quite a useful summary of what orexins do on the Frontiers in Endocrinology website. Their precursors are released from the hypothalamus and one of their main functions is to promote wakefulness. So by blocking their action, you can help people to feel sleep better. And if, like me, you can’t remember being taught any of this at med school, they were only discovered in the late 1990s.
When can it be used?
It can be used for treating insomnia in adults if:
- Symptoms are on 3 nights or more per week AND
- Symptoms have lasted for at least 3 months AND
- Where daytime functioning is considerably affected AND
- CBTi has either been tried and was not effective, or where it is not available or is not suitable.
