Table 1.
Adverse effects of conventional hypnotics and potential effects of orexin antagonists. The side effects of conventional drugs are well documented, but little is known about the clinical effects of orexin antagonists. Some effects such as morning sedation may depend on the compound’s pharmacokinetics. The frequency of these effects is indicated by the following symbols: ++, common; +, occasional; −, rare
| Benzodiazepines (e.g., clonazepam, lorazepam) | Nonbenzodiazepines (e.g., zolpidem, zaleplon) | Sedating antidepressants (e.g., trazodone, doxepin) | Orexin antagonists | |
|---|---|---|---|---|
| Morning sedation | + | + | + | + |
| Hypnagogic hallucinations, sleep paralysis | − | − | − | + |
| Unsteady gait, falls | ++ | + | + | +/− |
| Confusion | ++ | + | ++ | +/− |
| Amnesia | + | + | − | − |
| Dependence and abuse | + | +/− | − | − |
| Rebound insomnia | + | + | − | − |
| Respiratory depression | + | +/− | − | − |
| Orthostasis | − | − | + | − |
| Anticholinergic effects | − | − | ++/+ | − |