Behind The Headlines: Can a sleeping pill aid weight loss?

A sleeping pill that does not impair cognitive function is in development. Mark Pownall reports.

WHAT DID THE PAPERS SAY?

A pill that helps you fall asleep at night, improves memory and promotes weight loss is under scientific development, according to media reports.

The pill does not have the worrying side-effects of traditional sleeping pills, such as addiction and daytime drowsiness.

In lab tests, rats slept more soundly and performed better at maze tests following treatment with the drug, which blocks the hormone orexin. Mice on the drug were found to have more dream phase (REM) sleep.

This could mean the drug will improve memory because REM sleep is 'when memory is hard wired into the brain', according to media reports.

WHAT IS THE STORY?

Actelion, the Swiss-based pharmaceutical company which develops clinically active peptides for therapeutic use, is carrying out research into orexins.

These are neuropeptides which affect sleep/wake states and influence food and water intake.

Their lead compound is an orexin receptor antagonist that increased total sleep time and caused a small increase in REM sleep time in rats.

In phase-one trials there was no evidence of tolerance or motor impairment, which are the main drawbacks of current treatments.

The treatment is in the early stages of development and has only just moved into phase-two clinical trials.

However, this represents a major achievement because synthesising peptide receptor agonists and antagonists is difficult. No drug targeting the orexin system has before reached this stage of development.

WHAT DID THE RESEARCHERS SAY?

Actelion chief executive officer Jean Paul Clozel said results from maze tests showed that the memory of rats on the orexin receptor antagonist was better than those on the conventional sleeping treatment, zolpidem.

He said that phase-two clinical trials had just begun and if all the trials progressed, Actelion hoped to launch a hypnotic treatment in 2012.

WHAT DO OTHER EXPERTS THINK?

Dr Shadrad Taheri, lecturer in medicine at the University of Bristol, said that treatments that interacted with the orexin system might have effects beyond helping insomniac patients sleep.

'Being overweight is associated with sleep deprivation and orexin is thought to be involved in feeding regulation, so a beneficial effect of blocking the orexin system could be that the person will eat less,' he said.

But he stressed that there were no published peer-reviewed data for the Actelion drug.

'We don't know enough about this particular drug to comment fully,' he said.

But Dr Taheri admitted that there was a need for better hypnotic treatments: 'All available drugs are disappointing and few people can use them long-term.'

He also speculated that this group of candidate drugs could have the potential for treating substance abuse and addiction because they acted on the same system that causes narcolepsy.

Patients with narcolepsy rarely become dependent on the amphetamines that they take to control their disorder, and to which most users without narcolepsy rapidly become addicted.

Orexin receptor antagonists could therefore play a role in the management of drug abuse.

'Any drug that manipulates the orexin system could affect all these neurological systems,' Dr Taheri said, but added that there was no indication what effect, if any, the drug in development by Actelion would have.

Sleep specialist Dr Rafael Pelayo, of the University of Stanford in California, said: 'It remains to be seen whether the changes in REM sleep and memory improvement are significant.'

But he acknowledged that the differences in the symptoms of rats on the treatment, compared with previous drugs, suggested that orexin-based therapies had a different mechanism of action.

www.actelion.com

INFORMING PATIENTS

- A sleeping pill that improves memory and aids weight loss will not be available for at least six years.

- Current sleeping pills can only be used in the short term and can have adverse effects on memory.

- Before taking a sleeping pill try sleep hygiene techniques, including regular bedtimes and hot, relaxing baths.

WHAT THE PAPERS SAID

"New sleeping pill claimed to boost memory, curb over-eating and prevent addiction" - The Guardian

"'Safer' sleep drug holds new hope of a good night's rest" - The Scotsman

"Sleeping pill could help you lose weight" - Daily Mail.

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