Hypnotics: orexin antagonists: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Hypnotics: orexin antagonists

Sample item

Suvorexant and lemborexant treat insomnia by

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Blocking orexin receptors to reduce wake drive

Dual orexin receptor antagonists block the wake-promoting neuropeptide orexin and so promote sleep without acting on the GABA system. Adverse effects include next-day somnolence and possibly sleep paralysis. They are contraindicated in narcolepsy.

Option by option

  • A. Blocking orexin receptors to reduce wake drive (correct)

    Correct. They block orexin signalling.

  • B. Agonising melatonin receptors

    Melatonin agonism is the mechanism of ramelteon.

  • C. Enhancing GABA-A chloride flow

    GABA-A enhancement is the mechanism of benzodiazepines and Z-drugs.

  • D. Inhibiting histamine release

    Histamine blockade is the mechanism of sedating antihistamines.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Blocking orexin receptors to reduce wake drive. Dual orexin receptor antagonists block the wake-promoting neuropeptide orexin and so promote sleep without acting on the GABA system.

Why is "Agonising melatonin receptors" not the answer?

Melatonin agonism is the mechanism of ramelteon.

Why is "Enhancing GABA-A chloride flow" not the answer?

GABA-A enhancement is the mechanism of benzodiazepines and Z-drugs.

Why is "Inhibiting histamine release" not the answer?

Histamine blockade is the mechanism of sedating antihistamines.

What concept does this question test?

It tests Hypnotics: orexin antagonists in Psychiatry. Adverse effects include next-day somnolence and possibly sleep paralysis. They are contraindicated in narcolepsy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hypnotics: orexin antagonists?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.