suvorexant and Depressive-Disorder--Major

A 59-year-old woman on daily peritoneal dialysis for end-stage renal failure received care at an outpatient psychiatric clinic for her diagnoses that include major depressive disorder, generalised anxiety disorder and insomnia disorder. Although there was partial improvement in the patient's mood and anxiety symptoms with antidepressant treatment, insomnia remained a persistent complaint despite adequate trials of different sleep medications. The novel hypnotic, suvorexant (Belsomra, Merck & Co.) was then initiated at the recommended bedtime dose of 10 mg and was followed by a 15 mg dose the following night. Within an hour after taking her second suvorexant dose, the severity of patient's depression symptoms worsened and was accompanied by new onset of suicidal thoughts.

Topics: Antidepressive Agents; Azepines; Depressive Disorder, Major; Diagnosis, Differential; Female; Humans; Hypnotics and Sedatives; Middle Aged; Orexin Receptor Antagonists; Sleep Initiation and Maintenance Disorders; Suicidal Ideation; Treatment Outcome; Triazoles