Is bigger better? Analysis of efficacy and safety of lemborexant 5 versus 10 mg in insomnia patients.

OBJECTIVE

To assess the rationale for using lemborexant 10 mg as a starting dose or for those with partial response to 5 mg for the management of insomnia.

METHODS

A review of MEDLINE, regulatory reports, and Canadian Agency for Drugs and Technologies in Health data was conducted.

KEY FINDINGS: Lemborexant 10 mg as an initial dose offers minimal improvement in sleep metrics over 5 mg but increases somnolence risk. No evidence supports dose escalation for partial responders to 5 mg.

CONCLUSION

Lemborexant 10 mg is generally not advisable as an initial or escalated dose due to higher harm risk and unlikely clinical benefit.