© 2022 American Academy of Sleep Medicine. 2022 18(5):1459-1462.ĭORA cataplexy dual orexin receptor antagonist hyperactive delirium lemborexant narcolepsy orexin sleep attack. Narcolepsy-like symptoms triggered by lemborexant in the context of hyperactive delirium in a patient with bipolar depression: a case report. NARCOLEPSY IS CHARACTERIZED by a complaint ofexcessive daytime sleepiness and symptoms of abnormalREM sleep (cataplexy, sleep paralysis, hypnagogic halluci-nations). This case also emphasizes that clinicians must be very careful when they prescribe lemborexant to patients who experience hyperactive delirium. The diagnosis is typically made after a long delay that burdens the disease severity. Her case suggests that lemborexant could trigger narcolepsy-like symptoms in patients with hyperactive delirium, even those with no history of narcolepsy. Narcolepsy is a lifelong disease, manifesting with excessive daytime sleepiness and cataplexy, arising between childhood and young adulthood. She experienced narcolepsy-like symptoms on 2 occasions after she was administered lemborexant, in the context of hyperactive delirium, but not in a relaxed state. Her previous results on the Multiple Sleep Latency Test excluded the diagnosis of narcolepsy. We describe the case of a 79-year-old Japanese woman with bipolar depression who experienced lemborexant-induced cataplexy and sleep attack. The symptoms of cataplexy may appear weeks or even years after the onset of EDS. It is often triggered by sudden, strong emotions such as laughter, fear, anger, stress, or excitement. Some common symptoms are: getting weak in the knees, drooping face or eyelids, slurred speech, head dropping, arm or leg weakness, and even falling down. CataplexyThis sudden loss of muscle tone while a person is awake leads to weakness and a loss of voluntary muscle control. The weakness may affect your entire body or just one part of it. section the review states the absence of cataplexy in the development programs does not necessarily exclude the risk of drug-induced narcolepsy from. Although the blockade of orexin signaling has triggered narcolepsy-like symptoms in rodents, there is currently no evidence of lemborexant inducing narcolepsy-like symptoms in humans. Cataplexy: This is sudden muscle weakness. Dual orexin antagonists induce physiological sleep by blocking orexin receptors. Lemborexant is a dual orexin antagonist and is considered a safe and effective hypnotic.
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