Effects of Orexin Receptor Antagonist on Cognitive Function in Adults: A Systematic Review

Orexin receptor antagonists (ORAs) are the emerging class of hypnotics used for the treatment of insomnia. However, from the available literature, the effect of ORA on cognitive functions is not clear yet. Therefore, the current study aimed to systematically evaluate the effect of ORA on cognitive function from available clinical studies. The extensive literature search was conducted in various databases, including Pubmed, Embase, Cochrane Library, and clinicaltrials.gov, using suitable keywords. The quality of the included studies was evaluated using the Cochrane risk of bias tool (ROB2). We obtained a total of 450 articles from different databases. Finally, 07 articles met the inclusion criteria and were included in the current systematic review for qualitative analysis. Available literature showed conflicting results, with few studies showing no impact of ORA on cognitive function, while others reported dose-dependent adverse effects of ORA on cognitive function. The risk of bias in included studies was found to be low. In conclusion, ORA is generally safe in clinical doses. However, it is important to note that there is a dose-dependent decline in cognitive function after the administration of ORA. Therefore, clinicians must be careful while prescribing ORA and adjust the dose as per the needs of the individual patients and the potential risk factors.