Introduction

Solriamfetol (trade name: Sunosi) has been approved in Germany since January 2020 for the treatment of narcolepsy in adults. It is supposed to improve alertness and reduce excessive sleepiness during the day.

Narcolepsy is a disorder that affects the sleep-wake cycle controlled by the brain. People who have narcolepsy are typically very tired during the day and have a strong urge to sleep. Sleeping “attacks” are also possible: These are sudden episodes of sleep that may even occur while the person is eating or speaking.

People with narcolepsy also commonly experience short episodes of muscle weakness (failure) during the day. This can result in falls. Doctors call this “cataplexy.” It most often occurs in emotional situations, such as when someone is scared, surprised or laughing.

Solriamfetol influences the metabolism of the chemical messengers dopamine and noradrenaline in the brain.

Application

Solriamfetol is used in tablet form, in the doses 75 mg and 150 mg. It is taken once a day in the morning after you wake up.

The recommended dose when starting treatment is 75 mg of solriamfetol. This dose can be increased after three days if necessary. The maximum daily dose of solriamfetol is 150 mg.

Other treatments

There are various other medications for the treatment of narcolepsy. The dose of these medications is adjusted on an individual basis. The medications modafinil and pitolisant are suitable for people who do not have cataplexy. People who have cataplexy can use sodium oxybate or pitolisant.

Assessment

In 2020, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether solriamfetol has any advantages or disadvantages compared to the standard treatments for narcolepsy.

But the manufacturer didn’t provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of solriamfetol (Sunosi).