The selective orexin-2 receptor antagonist seltorexant improves sleep: An exploratory double-blind, placebo controlled, crossover study in antidepressant-treated major depressive disorder patients with persistent insomnia:

Background:Insomnia is common in patients with major depressive disorder. Although antidepressants improve mood, insomniaoften persists as a result of physiological hyperarousal. The orexin-2 receptor is increasingly being recognized as a new target for the treatment of persistent insomniain major depressive disorder.Aim:This exploratory study investigated the effects of seltorexant on objective sleep parameters and subjective depressive symptoms in antidepressant treated major depressive disorderpatients with persistent insomnia.Methods:Twenty male and female patients received a single dose of 10, 20, 40 mg seltorexant and placebo with a washoutperiod of seven days in a double-blind four-way crossover study. Effects on latency to persistent sleep, total sleep time and sleep efficiency were assessed with polysomnography. Subjective changes in mood were explored by the Quick Inventory of Depressive Symptomatology Self-Report. Safety was recorded and suicidal ideationand behavior were assessed with th...