Insomnia medication for alcohol use disorder?

Researchers are recommending full-scale human trials after an insomnia drug helped a man withdraw from his 16-drinks-a-day addiction.

A 31-year-old man, who consumed 16 alcoholic drinks a day, had poor liver function and suffered from insomnia, withdrew from alcohol with the help of the insomnia drug suvorexant (Belsomra).

A Florey-led report, published in Clinical Case Reports, describes the case.

The patient was treated at St Vincent’s Melbourne’s Drug and Alcohol withdrawal unit (under the care of Professor Yvonne Bonomo) for one week and continued the treatment at home for three months, said Florey Professor Andrew Lawrence.

“After 13 weeks on suvorexant he’d had a complete turnaround. He had stopped drinking all together, his liver function had improved and he no longer had insomnia. This is a remarkable result.”

Insomnia features strongly in both withdrawal and relapse to alcohol consumption, Lawrence said.

Suvorexant is a dual orexin receptor antagonist, which suppresses wakefulness by essentially blocking the brain’s orexin system, he said.

“Although this case report is of just one person’s experience, we already have abundant evidence in preclinical animal models supporting a role for the orexin system in alcohol use disorder.”

The patient’s experience suggests dual orexin receptor antagonists could be a new weapon to help treat alcohol use disorder, Lawrence said.

“The next step should be to conduct larger human trials to test whether suvorexant helps a broader group of people who have both alcohol use disorder and insomnia.”

The study was funded in part by the Victorian State Government’s Medical Research Acceleration Fund.

Minister for Education and Medical Research Hon Ben Carroll said, “We know addiction can have a detrimental impact on someone’s quality of life and mental health. That’s why the work of The Florey’s medical researchers is so important, helping to uncover new ways to treat alcohol use disorder.”

“Sleep-associated problems affect close to half of all people with alcohol use disorder. Yet sleep disruption is an often-overlooked symptom that can hamper recovery from alcohol use disorder,” Minister for Mental Health Hon Ingrid Stitt said.

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