"please keep me updated about oximeters "
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Novel Pill-Duo for Sleep Apnea
Just came across this on my Linked-In Account. Will Twitter it too! Don't shoot the messenger LOL. Just thought you all might like to see it:-
ps Sorry about the big font - it's because I copied + pasted it!
Attempts to treat sleep apnea with a pill continue - and here is one more attempt
with one - actually two pills. Researchers from Chicago used 4 weeks of a
an interesting combination of combination of fluoxitene, a serotonin
reuptake inhibitor, and ondansetron (a 5HT3 antagonist) in 35 adults
with sleep apnea. Participants received either drug alone, only placebo
and the combination of both. A 40% reduction in AHI was seen at the end
of the study period. Interesting data -- may point to some potential
novel targets for the future.
ps Sorry about the big font - it's because I copied + pasted it!
Attempts to treat sleep apnea with a pill continue - and here is one more attempt
with one - actually two pills. Researchers from Chicago used 4 weeks of a
an interesting combination of combination of fluoxitene, a serotonin
reuptake inhibitor, and ondansetron (a 5HT3 antagonist) in 35 adults
with sleep apnea. Participants received either drug alone, only placebo
and the combination of both. A 40% reduction in AHI was seen at the end
of the study period. Interesting data -- may point to some potential
novel targets for the future.
Views: 205
Replies to This Discussion
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Permalink Reply by Mary Z on
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This is an unusual combination of drugs. Prozac and Zofran- an SSRI and an antinausea drug. I wonder what put them on this track?
Thanks, Kath.
Mary Z.
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Permalink Reply by Kath Hope www.hope2Sleep.co.uk on
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That's just what I thought Mary. Thought antidepressants made the apneas worse due to their sedative effect (or maybe Prozac doesn't work that way). The other drug is being patented as a sleep apnea treatment. The article does say "one more attempt" so we'll see...........
Mary Z said:This is an unusual combination of drugs. Prozac and Zofran- an SSRI and an antinausea drug. I wonder what put them on this track?
Thanks, Kath.
Mary Z.
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Permalink Reply by Steven Y. Park, MD on
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I'm not sure about these particular drugs, but many anti-depressants suppress REM sleep. So by lessening REM, you'll have less apneas, since that's when your throat muscles relax the most. Mirtazapine actually lowered the AHI by 50%.
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Permalink Reply by Mike on
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great post, Kath. thanks. here's an abstract of the study i found at http://www.ncbi.nlm.nih.gov/pubmed/20614859:
Sleep. 2010 Jul 1;33(7):982-9.
Prospective trial of efficacy and safety of ondansetron and fluoxetine in patients with obstructive sleep apnea syndrome.
Prasad B, Radulovacki M, Olopade C, Herdegen JJ, Logan T, Carley DW.
Center for Narcolepsy, Sleep and Health Research, Department of Medicine, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL 60612, USA.
Abstract
STUDY OBJECTIVE: Incremental withdrawal of serotonin during wake to sleep transition is postulated as a key mechanism that renders the pharyngeal airway collapsible. While serotonin promotion with reuptake inhibitors have demonstrated modest beneficial effects during NREM sleep on obstructive sleep apnea (OSA), animal studies suggest a potential therapeutic role for selective serotonin receptor antagonists (5-HT3) in REM sleep. We aimed to test the hypothesis that a combination of ondansetron (Ond) and fluoxetine (Fl) may effectively reduce expression of disordered breathing during REM and NREM sleep in patients with OSA. DESIGN AND SETTING: A prospective, parallel-groups, single-center trial in patients with OSA. PARTICIPANTS: 35 adults with apnea hypopnea index (AHI) > 10; range 10-98. INTERVENTION: Subjects were randomized to placebo, n = 7; Ond (24 mg QD), n = 9; Fl (5 mg QD) + Ond (12 mg QD), n = 9; and Fl (10 mg QD) + Ond (24 mg QD), n = 10. MEASUREMENTS AND RESULTS: AHI was measured by in-lab polysomnography after a 7-day no-treatment period (Baseline) and on days 14 and 28 of treatment. The primary endpoint was AHI reduction at days 14 and 28. OND+FL resulted in approximately 40% reduction of baseline AHI at days 14 and 28 (unadjusted P < 0.03 for each) and improved oximetry trends. This treatment-associated relative reduction in AHI was also observed in REM and supine sleep. CONCLUSIONS: Combined treatment with OND+FL is well-tolerated and reduces AHI, yielding a potentially therapeutic response in some subjects with OSA.
PMID: 20614859 [PubMed - in process]PMCID: PMC2894441 [Available on 2011/1/1]
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Well, I've just looked up all the side effects of these drugs in my daughter's medical book, and I think I'll stick with CPAP!
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Permalink Reply by Tim on
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I may have to try this; I am currently taking Prozac for FMS and i have a big box of left over Zofran.
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Permalink Reply by pittsburgh_leo on
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Hey Kath,
When I saw your post, I thought it was the same one that I saw earlier this year. The story below got very little media coverage, but could you imagine the marketing for a weight loss drug that can also decrease AHI. Stay tuned.....
Leo
Could an obesity pill combat sleep apnea? That's the question being asked by a small study by Vivus, a tiny biotech.
Qnexa, Vivus' pill, combines low-dose phentermine, a weight-loss drug, with topiramate, an epilepsy medicine that was sold by Johnson & Johnson under the brand name Topamax. In large clinical trials, it helped patients lose some weight and it has been submitted to the Food and Drug Administration as a weight-loss drug. Now Vivus is presenting results from a small trial testing it as a sleep apnea treatment.
Overweight patients are also at risk for sleep apnea, in which breathing is partially or completely obstructed during sleep. Vivus says the condition affects 18 million Americans.
The new study involved only 45 patients and a single center, but those who recieved Qnexa scored better on a test measuring the severity of their apnea than those who did not get the drug. Much larger studies will have to be conducted. If Qnexa really is combating apnea, it could be either helping people lose weight or working through some unknown mechanism.
Tags: FDA, obesity, sleep apnea
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Another interesting one Leo. Let us know if you hear any more please. I shall stay tuned....!
Leo Besterci said:Hey Kath,
When I saw your post, I thought it was the same one that I saw earlier this year. The story below got very little media coverage, but could you imagine the marketing for a weight loss drug that can also decrease AHI. Stay tuned.....
Leo
Could an obesity pill combat sleep apnea? That's the question being asked by a small study by Vivus, a tiny biotech.
Qnexa, Vivus' pill, combines low-dose phentermine, a weight-loss drug, with topiramate, an epilepsy medicine that was sold by Johnson & Johnson under the brand name Topamax. In large clinical trials, it helped patients lose some weight and it has been submitted to the Food and Drug Administration as a weight-loss drug. Now Vivus is presenting results from a small trial testing it as a sleep apnea treatment.
Overweight patients are also at risk for sleep apnea, in which breathing is partially or completely obstructed during sleep. Vivus says the condition affects 18 million Americans.
The new study involved only 45 patients and a single center, but those who recieved Qnexa scored better on a test measuring the severity of their apnea than those who did not get the drug. Much larger studies will have to be conducted. If Qnexa really is combating apnea, it could be either helping people lose weight or working through some unknown mechanism.
Tags: FDA, obesity, sleep apnea
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the takeaway from all of this that i get is that this is an exciting time in the life of the Sleep Apnea patient -- our market potential is being understood and responded to with an exciting number of innovative approaches to treatment.
Kath Hope www.hope2Sleep.co.uk said:Another interesting one Leo. Let us know if you hear any more please. I shall stay tuned....!
Leo Besterci said:Hey Kath,
When I saw your post, I thought it was the same one that I saw earlier this year. The story below got very little media coverage, but could you imagine the marketing for a weight loss drug that can also decrease AHI. Stay tuned.....
Leo
Could an obesity pill combat sleep apnea? That's the question being asked by a small study by Vivus, a tiny biotech.
Qnexa, Vivus' pill, combines low-dose phentermine, a weight-loss drug, with topiramate, an epilepsy medicine that was sold by Johnson & Johnson under the brand name Topamax. In large clinical trials, it helped patients lose some weight and it has been submitted to the Food and Drug Administration as a weight-loss drug. Now Vivus is presenting results from a small trial testing it as a sleep apnea treatment.
Overweight patients are also at risk for sleep apnea, in which breathing is partially or completely obstructed during sleep. Vivus says the condition affects 18 million Americans.
The new study involved only 45 patients and a single center, but those who recieved Qnexa scored better on a test measuring the severity of their apnea than those who did not get the drug. Much larger studies will have to be conducted. If Qnexa really is combating apnea, it could be either helping people lose weight or working through some unknown mechanism.
Tags: FDA, obesity, sleep apnea
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Permalink Reply by Brian Smith on
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Surely this all begs the question?
Do thin/normal weight/BMI<27 people snore/have OSA? If all OSA sufferers got their weight down to normal levels would their OSA go away?
If they don't and/or it did then in our heart of hearts we know what we've got to do...
Pills could help there I suppose; with losing weight I mean. As could gastric bands, stomach bypasses, will power (no, that one'll never work, not with me anyway).
Most anti-depressants play havoc with sleeping patterns; could be piling one problem on top of another?
Has anybody tried using Provigil to raise alertness levels during the day so that their activity levels (can) increase?
Brian Smith
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Brian, I have taken Provigil at a low dose of 200 mg/day. Now I take Nuvigil at 250 mg /day. I continue to have excessive daytime sleepiness and the Nuvigil definitely helps keep me awake and alert during the day so I don't have the nap/insomnia cycle. I have hypersomnia, not narcolepsy. I have yet, for more than a couple of days lately, had a normal AHI of under 5. I am watching my diet and losing some weight so I'm hoping that will finally tip the balance toward normal numbers (AHI and AI) for me.
Has anybody tried using Provigil to raise alertness levels during the day so that their activity levels (can) increase?
Brian Smith
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Permalink Reply by Banyon on
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Brian Smith said, "Do thin/normal weight/BMI<27 people snore/have OSA? If all OSA sufferers got their weight down to normal levels would their OSA go away?"
This is a myth once believed by most doctors. My BMI was 25 and I have driven it down to 22 through exercise, low-carb diet and CPAP therapy and am in athletic shape. My OSA is still at the severe level and the pressure requirements have not declined. In the meantime I have met quite a few people who are slim and have severe OSA.
One of the doctor members here has written, "It is not the size of the neck on the outside, it is the size of the airway inside the neck."
The problem is usually a narrow jaw causing a narrow airway.
There are likely some people who could effectively treat OSA by losing weight and avoiding backsleeping, but it doesn't work for most people.
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