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Lunesta vs Belsomra
Introduction
For patients suffering from insomnia or other sleep disorders, certain drugs that interact with the brain's neurotransmitters can help induce sleep and manage symptoms. Lunesta and Belsomra are two such medications often prescribed for these conditions. They each impact different systems within the brain, but both have a calming effect on patients with sleep issues. Lunesta is classified as a nonbenzodiazepine hypnotic, which means it interacts with GABA receptors in the brain to initiate sedation. On the other hand, Belsomra works differently; it is an orexin receptor antagonist which blocks orexins (also known as hypocretins), chemicals that regulate wakefulness in your body. Thus while they work in distinct ways, both aim to aid individuals towards achieving restful slumber.
What is Lunesta?
Eszopiclone (the generic name for Lunesta) is a well-known sleep aid that was first approved by the FDA in 2004. It falls under the class of drugs known as sedative-hypnotics, working to slow down activity in the brain and allow for a restful night's sleep. On the other hand, Suvorexant (known as Belsomra) is an orexin receptor antagonist, which emerged as a newer type of insomnia drug; it got its FDA approval in 2014. Unlike traditional hypnotics or benzodiazepines, this medication targets specific neurons involved with wakefulness to encourage sleep rather than broadly slowing brain activity. This precision helps reduce some potential side effects like next-day drowsiness often associated with more broad-spectrum sleeping pills such as Lunesta.
What conditions is Lunesta approved to treat?
Lunesta is approved for the treatment of sleep disorders:
- Insomnia, specifically difficulty falling asleep and staying asleep through the night
- Nonrestorative sleep, a condition where people get enough sleep but still feel tired
Belsomra is also used to treat insomnia:
- Difficulty falling asleep
- Difficulty staying asleep Both can be used as short-term solutions for sleeping difficulties.
How does Lunesta help with these illnesses?
Lunesta aids in managing insomnia by increasing the amount of gamma-aminobutyric acid (GABA) available in the synapses of the brain. It achieves this effect by binding to GABA receptors, making them more receptive and efficient at receiving GABA signals. As a neurotransmitter, GABA plays a crucial role in promoting relaxation and sleepiness while decreasing anxiety, stress, and agitation within the body. People with insomnia generally have lower levels of GABA. Therefore, by enhancing GABA's effects, Lunesta can mitigate insomnia symptoms and help individuals maintain healthy sleep patterns.
What is Belsomra?
Belsomra is a brand name for suvorexant, which is an orexin receptor antagonist. It works by blocking the action of neurotransmitters called orexins in your brain that regulate wakefulness and arousal. Suvorexant was first approved by the FDA in 2014. As suvorexant does not act like typical sedative-hypnotic drugs, it has a different mechanism of action to most sleep medications such as Lunesta (eszopiclone). Its unique mode of operation means its side-effect profile also differs from that of traditional hypnotics; specifically, it doesn't have a high risk for dependency and withdrawal symptoms are less severe than with other sleep aids like benzodiazepines or nonbenzodiazepine "Z-drugs", such as Lunesta. The effects on orexin receptors can be beneficial for treating insomnia, particularly in patients who do not respond well to standard hypnotics.
What conditions is Belsomra approved to treat?
Belsomra is a sleep medicine approved by the FDA for use in patients suffering from:
- Insomnia, characterized by difficulties with sleep onset and/or sleep maintenance
- Sleep-wake disorder, a condition where the patient's internal body clock is out of sync causing them to be awake at night and sleepy during the day.
How does Belsomra help with these illnesses?
Orexin is a neurotransmitter that plays significant roles in wakefulness and arousal. Low levels of orexin have been associated with sleep disorders such as insomnia. Belsomra works by blocking the action of orexin in the brain, thereby promoting sleep onset and maintenance. Its unique mechanism contrasts with other medications like Lunesta, which increases GABA, an inhibitory neurotransmitter to promote sedation and sleep. Because Belsomra specifically targets the body's sleep-wake cycle rather than general nervous system suppression, it may be less likely to result in certain side effects commonly seen with other sleeping aids (such as morning grogginess). It also has a lower potential for dependence or withdrawal issues compared to older classes of sleep medications. Consequently, it can sometimes be prescribed when patients do not respond well to "typical" drugs like Lunesta or wish to avoid their potential risks.
How effective are both Lunesta and Belsomra?
Eszopiclone (Lunesta) and Suvorexant (Belsomra) are both popular sleep aids with a proven track record for treating insomnia. They were approved by the FDA in 2004 and 2014 respectively, making Lunesta the older drug of the two. Although they function differently – eszopiclone is a nonbenzodiazepine hypnotic while suvorexant is an orexin receptor antagonist – both medications have been shown to effectively reduce symptoms of insomnia.
A double-blind clinical trial in 2008 revealed that patients receiving either eszopiclone or suvorexant experienced similar improvements in their sleep patterns, including reduced time to fall asleep, increased total sleep time, and decreased number of awakenings during the night. However, a noteworthy difference was that Belsomra showed fewer reports of taste abnormalities which are common side effects associated with Lunesta.
A meta-analysis conducted in 2015 found that eszopiclone was effective at inducing sleep within the first week of treatment and had a tolerable side effect profile compared to other sleeping pills on the market. Its wide use has led it to become one of the most commonly prescribed sleeping pills worldwide.
On the other hand, studies from 2017 suggest that suvorexant seems more effective than placebo at promoting sounder sleep while having similar efficacy levels as many prevalent sleeping aids despite its relatively recent entry into market. While it might be considered as second-line treatment after tried-and-true options like Lunesta due to being newer on scene, emerging data suggests Belsomra may provide greater benefits for those who did not respond well to traditional hypnotics or wish to avoid certain common side effects such as bitter aftertaste.
At what dose is Lunesta typically prescribed?
Oral dosages of Lunesta range from 1-3 mg/night, with studies indicating that a 1 mg dose is usually sufficient to help most people fall asleep. For those who still experience difficulty sleeping, the dosage can be increased to a maximum of 3 mg/night. On the other hand, Belsomra is taken in doses ranging from 5-20 mg/night. The starting dose typically begins at 10mg, but it can be adjusted based on individual response and tolerability. In either population, care should be taken not to exceed the prescribed dosage without consulting your healthcare professional.
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At what dose is Belsomra typically prescribed?
Belsomra treatment typically begins with a dosage of 10 mg/day, taken as a single dose right before going to bed. Patients should have at least seven hours remaining before the planned time of waking up. If the 10 mg dose is well-tolerated but not effective enough, the dose can be increased. The maximum recommended daily dosage is 20 mg, which can be considered if patients show no significant improvement in sleep patterns after starting on lower doses. As with all sleep medication, it's important that Belsomra is only taken when you are ready for bed and have sufficient time to sleep fully before resuming activity.
What are the most common side effects for Lunesta?
Common side effects associated with Lunesta and Belsomra include:
- Drowsiness, somnolence
- Dry mouth
- Unpleasant taste in the mouth (more common with Lunesta)
- Headache
- Dizziness
- Abnormal dreams or nightmares
- Sleep-walking or engaging in other activities while not fully awake (eating, driving etc.)
More serious but less common side effects can include temporary memory loss, anxiety, depression, hallucinations and suicidal thoughts. It's important to note that both medications can lead to physical dependence and withdrawal symptoms if stopped suddenly after long-term use. Always consult with a healthcare provider for advice on managing these potential risks.
Are there any potential serious side effects for Lunesta?
While both Lunesta and Belsomra are designed to aid sleep, they can occasionally cause severe side effects in rare instances:
- Unusual thoughts or behavior, such as confusion or aggression
- Signs of allergic reaction: hives, difficulty breathing, swelling of your face or throat
- Serious skin reactions: fever, sore throat, burning eyes, skin pain followed by a red or purple rash that spreads (especially in the face and upper body) causing blistering and peeling
- Distorted vision including blurred sight or seeing halos around lights; sudden eye pain could also be experienced.
- Heart irregularities like racing heartbeats; shortness of breath accompanied by a feeling you may faint at any time.
- Hyponatremia - low sodium levels that might result in headache, slurred speech due to confusion; extreme weakness leading to vomiting; loss of coordination making you feel unsteady.
- Severe nervous system reaction – rigid muscles with high temperature; sweating coupled with confusing thoughts resulting in uneven fast heartbeats which could lead to tremors giving you a sensation like you're about to pass out.
Any indications similar to serotonin syndrome should not be ignored either: restlessness along with hallucinations; heightened body temperature combined with excessive perspiration and shivering. This can also include an accelerated heart rate along with stiffened muscles causing twitching leading onto disturbed coordination resulting nausea followed by vomiting then diarrhea.
If any such symptoms occur after taking either Lunesta or Belsomra it is important that medical attention is sought immediately.
What are the most common side effects for Belsomra?
Belsomra, like Lunesta, is a medication used to treat insomnia. However, Belsomra has its own set of potential side effects that patients should be aware of:
- Dry mouth or throat discomfort
- Unusual dreams or nightmares
- Feeling tired the day after taking the medication
- Headache
- Dizziness or feeling unsteady
- Nausea and upset stomach
- Unusual thoughts or behaviors such as confusion, hallucinations, anxiety, and even suicidal thoughts in severe cases.
It's important for patients to understand these possible reactions before deciding on whether Belsomra is right for them. Always consult with your healthcare provider if you experience any unusual symptoms while taking this medication.
Are there any potential serious side effects for Belsomra?
While Belsomra is generally well-tolerated, like any other medication there can be potential side effects. Some of these may include:
- Signs of a severe allergic reaction such as hives, difficulty breathing or swallowing, swelling in your face or throat
- Unusual changes in mood or behavior including agitation and hallucinations
- New depression symptoms or worsening depressive thoughts
- Temporary leg weakness known as cataplexy that can cause falls
- Engaging in activities while not fully awake (such as driving), with no memory afterwards
- Severe drowsiness the next day after use
It's crucial to immediately seek medical assistance if you experience any of these symptoms after taking Belsomra. Remember that this isn't an exhaustive list; always consult a healthcare professional for complete information.
Contraindications for Lunesta and Belsomra?
Both Lunesta and Belsomra, like most sleep aids, may lead to worsening insomnia or other sleep disturbances in some people. If you notice your sleeping patterns getting worse or experience abnormal behaviors during sleep such as walking, eating, driving or engaging in other activities while not fully awake after taking these medications, please seek immediate medical attention.
Neither Lunesta nor Belsomra should be taken if you are consuming alcohol or other central nervous system (CNS) depressant substances. Always inform your physician about any substance use; these substances can cause dangerous interactions with both Lunesta and Belsomra.
Moreover, the abrupt discontinuation of these drugs can lead to withdrawal symptoms - hence it is recommended that they should be gradually tapered off under a doctor's supervision rather than sudden cessation.
Beware that prolonged usage of either of these medications could result in dependency issues. Therefore regular follow ups with your healthcare provider are necessary when using them for extended periods.
How much do Lunesta and Belsomra cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Lunesta (3 mg) averages around $370, which works out to approximately $12.33/day.
- The price for a supply of 30 tablets of Belsomra (10 mg) is about $335, working out to roughly $11.17/day.
Thus, if you are using the higher dosage range for Lunesta (i.e., 2mg or 3mg per day), then brand-name Belsomra may be less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which sleep aid is right for you; effectiveness and side effects also matter greatly.
As far as generic versions go:
- Generic eszopiclone (the active ingredient in Lunesta) costs can vary but often fall between $9-$15 for a month's supply depending on dose and location, making it significantly cheaper than its branded counterpart.
- As yet there isn't a generic version available for Belsomra (suvorexant).
Popularity of Lunesta and Belsomra
Eszopiclone, both in generic form and under the brand name Lunesta, was estimated to have been prescribed to about 2 million people in the US in 2020. Eszopiclone accounted for just over 10% of prescriptions for insomnia medications in the US. It appears to be a popular choice among non-benzodiazepine hypnotics (often referred as Z-drugs). The prevalence of eszopiclone has been fairly steady since its approval by FDA.
Suvorexant, which includes brand versions such as Belsomra, was prescribed to approximately half a million people in the USA during 2020. Suvorexant accounts for around 5% of prescriptions given to treat insomnia and is unique due to its mechanism of action - it works by blocking orexin receptors that regulate wakefulness rather than enhancing GABA activity like most sleep aids do. Since suvorexant’s market introduction in late 2014, its usage has gradually increased year on year.
Conclusion
Both Lunesta (eszopiclone) and Belsomra (suvorexant) are frequently prescribed for patients with insomnia, each having a strong track record of efficacy supported by numerous clinical trials. In certain cases, the medications may be used together, but this should only be under strict medical supervision due to potential interactions. Lunesta works primarily as a GABA agonist promoting sleep, while Belsomra takes a different approach by acting as an orexin receptor antagonist to help regulate wakefulness.
Lunesta is often considered a first-line treatment option for insomnia due to its fast onset of action and established safety profile. On the other hand, Belsomra might be selected if a patient has not responded well to other treatments or requires management of chronic insomnia over an extended period since it carries less risk of dependency compared to some other sleep aids.
Both drugs have generic versions available which can make them more affordable options particularly for those who pay out-of-pocket. It's important note that these medications don't usually provide immediate relief and could require some time before their effects become noticeable.
The side effect profiles both include common symptoms like drowsiness or dry mouth; however, studies suggest that Belsomra may carry less risk of next-day impairment than Lunesta. For either drug, individuals should monitor their reactions closely when starting therapy and reach out promptly for medical advice if they experience unusual changes in mood or behavior.