The search for a blockbuster insomnia drug

Merck is working on a new insomnia drug that they claim has few of the sometimes nasty side effects of other drugs like Ambien. Ian Parker reports for the New Yorker.

If the Merck scientists succeeded at the F.D.A., they would be the first to bring an orexin-related drug to market. “It’s an amazing achievement,” Richard Hargreaves, the fourth colleague at the Hilton, said. “Everyone should be really proud.” But, he added, “my worry is that a new mechanism is being evaluated on the science of an old mechanism.”

“With Ambien, you’ve got a drug that’s got basically only onset,” Renger said, dismissively. That is, it sends you to sleep but might not keep you asleep. “Suvorexant has the onset, but it has the great maintenance, especially in the last third of the night, where other drugs fail.” And even though suvorexant keeps working longer than Ambien, suvorexant patients don’t feel groggier afterward, as you might expect. Impassioned, Renger imagined himself addressing the F.D.A.: “Why aren’t you giving this a chance?”

“Drugs usually have some side effects,” Schoepp said. “It’s all benefit-risk.” He added, “There is some dose where suvorexant will be ultimately safe-because nothing will happen. If you go low enough, it becomes homeopathic.”

They stood to go to their rooms. Schoepp murmured, “I’d love to take it right now.”

• drugs
• Ian Parker
• medicine
• Merck