title: On-the-road driving performance the morning after bedtime use of suvorexant 15 and 30 mg in healthy elderly.
abstract: Suvorexant is a first-in-class orexin receptor antagonist for treating insomnia. There is a general concern that hypnotics may impair next-morning driving ability.
  
  
  
  The objective of this study was to evaluate next-morning driving performance in older adults after single and repeated doses of suvorexant.
  
  
  
  Double-blind, randomized, placebo-controlled, 4-period crossover study in 24 healthy volunteers (10 females), aged 65-80 years. Subjects were treated with suvorexant (15 and 30 mg) for eight consecutive nights, zopiclone 7.5 mg nightly on days 1 and 8, and placebo. Driving performance was assessed on days 2 and 9 (9 h after dosing) using a 1-h standardized highway driving test in normal traffic, measuring standard deviation of lateral position (SDLP). Drug-placebo differences in SDLP >2.4 cm were considered to reflect clinically meaningful driving impairment.
  
  
  
  Driving performance as measured by SDLP was not impaired following suvorexant. Mean drug-placebo differences in SDLP following suvorexant 15 and 30 mg on day 2 and 9 were 0.6 cm or less. Their 90 % CIs were all below the threshold of 2.4 cm for clinical relevance and included zero, indicating effects were not clinically meaningful or statistically significant. Symmetry analysis showed no significant differences between the number of participants who had SDLP differences >2.4 cm and those who had SDLP differences <-2.4 cm following suvorexant.
  
  
  
  There was no clinically meaningful residual effect of suvorexant 15 and 30 mg on next-morning driving (9 h after bedtime dosing) in healthy older adults, as assessed by mean changes in SDLP and by the number of participants on drug versus placebo that exceeded a predetermined threshold for clinically meaningful impairment.
authors.affiliation: Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. a.vermeeren@maastrichtuniversity.nl.
authors.forename: Annemiek
authors.initials: A
authors.lastname: Vermeeren
authors.affiliation: SGS Life Science Services, Antwerp, Belgium.
authors.forename: Eva
authors.initials: E
authors.lastname: Vets
authors.affiliation: Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Eric F P M
authors.initials: EF
authors.lastname: Vuurman
authors.affiliation: Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Anita C M
authors.initials: AC
authors.lastname: Van Oers
authors.affiliation: Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Stefan
authors.initials: S
authors.lastname: Jongen
authors.affiliation: Merck Translational Medicine Europe, MSD Europe Inc., Brussels, Belgium.
authors.forename: Tine
authors.initials: T
authors.lastname: Laethem
authors.affiliation: Merck Translational Medicine Europe, MSD Europe Inc., Brussels, Belgium.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Heirman
authors.affiliation: Merck Translational Medicine Europe, MSD Europe Inc., Brussels, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: Bautmans
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: John
authors.initials: J
authors.lastname: Palcza
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Xiadong
authors.initials: X
authors.lastname: Li
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Troyer
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Wrishko
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: McCrea
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Sun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D053961:Azabicyclo Compounds / Q000494:pharmacology*; D001381:Azepines / Q000008:administration & dosage / Q000494:pharmacology*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D008297:Male; D010879:Piperazines / Q000494:pharmacology*; D011597:Psychomotor Performance / Q000187:drug effects*; D000068776:Sleep Aids, Pharmaceutical / Q000008:administration & dosage / Q000494:pharmacology*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy; D013997:Time Factors; D014230:Triazoles / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D053961:Azabicyclo Compounds; D001381:Azepines; D006993:Hypnotics and Sedatives; D010879:Piperazines; D000068776:Sleep Aids, Pharmaceutical; D014230:Triazoles; C515050:zopiclone; C551624:suvorexant
keywords: Driving; Elderly; Hypnotics; Orexin antagonist; Suvorexant; Zopiclone