Thursday, June 22, 2017 6:07:54 PM
My thoughts on the insomnia slide is what I had been discussing. My memory is that AVXL claimed that all 8 patients that noted any insomnia aspects on the HAM-D improved (someone else should confirm that). Others on this board have generalized this "100% improvement" rate to "Anyone with insomnia can be treated with 2-73". Obviously, this latter statement does not logically follow from the original statement or the data.
At least 4 others in response to my posts have noted that 2-73 could address factors that lead to insomnia in AD and therefore be an effective treatment. I agree with this statement and thought I was careful earlier to specify that I was referring to insomnia treatment in a general population. I also particularly agree with person that said it needs to be tested in subsequent trials. I would not be particularly sanguine about those prospects given the degree of data mining used to yield this result but agree its worthy of testing.
Other than when directly addressing a specific cause underlying insomnia does an insomnia treatment need to cause sedation. I hold the answer is yes for a general population. Put another way, it needs to cause somnolence...that is what you are going for. The example you give is melatonin. Melatonin is a very weak medication and efficacy is controversial. However, let's assume its effective via regulating circadian rhythms. If you give it at the wrong time of the day it will mess up the intended circad rhythm and cause sedation at the wrong time. Even if giving at the right time you'd be promoting the somnolence/sedation at what just happens to be the right time.
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