Recruiting

Orexin Antagonism for Suicide Risk: A Proof-of-Concept Clinical Trial

ClinicalTrials.gov IDNCT06854224

PhasePHASE2

Enrollment30

SponsorMarianne Goodman

Age18 Years

SexALL

I'm interested View official listing

Conditions studied

Suicide Risk, Major Depressive Disorder (MDD)

About this study

The goal of this proof-of-concept clinical trial is to evaluate the initial safety, feasibility, and tolerability of the orexin mixed antagonist suvorexant in a sample of veteran adults with Major Depressive Disorder and elevated suicide risk. The main question it aims to answer is: Is Suvorexant safe, feasible, and tolerable for participants? Participants will: * Take Surovexant every day for four weeks (10mg in the first two weeks and 20mg in the second two weeks) * Visit the medical center at the beginning of the study (week 1), after taking Suvorexant for two weeks (week 3) and following the full Suvorexant dose (week 5) for in-person assessments. * Fill out self-report assessments (remotely) at week 2 (after one week of Suvorexant) and week 4 (after three weeks of Surovexant)

Interventions

Drug: Suvorexant (dual orexin receptor antagonist) — Veteran patients with Major Depressive Disorder and elevated risk of suicide will receive the FDA-approved drug Suvorexant (brand name: Belsomra), a dual orexin receptor antagonist, for four weeks. Participants will take 10mg of Surovexant nightly for the first two weeks and 20mg of Surovexant nightly for the second two weeks.

Primary outcomes

Implicit Association Tests (IATs) (Weeks 1, 3, and 5)

Eligibility information

Inclusion Criteria: * Veteran * At least 18 years of age (up to 70 years) * Primary diagnosis of Major Depressive Disorder as determined by the study psychiatrist and confirmed by the Mini-International Neuropsychiatric Interview (MINI) * Lifetime suicide attempt history and suicidal ideation at baseline as determined by a score ≥2 on the Columbia-Suicide Severity Rating Scale (C-SSRS) Exclusion Criteria: * Clinically significant medical or neurological condition * Current use of strong CYP3A live enzymes or moderate CYP3A inhibitors or strong CYP3A inducers * Current use of digoxin * Currently pregnant, not using contraception, nursing, or trying to become pregnant * Active substance use disorder in the last six months, disorder, or current or past psychotic disorder, bipolar disorder, or obsessive-compulsive disorder * Severe traumatic brain injury * Imminent suicidal or homicidal risk * Free of unstable medical conditions or any contraindication to suvorexant (per FDA prescribing label) as determined by patient interview and review of available medical records.

Study locations

James J. Peters Veterans Affairs Medical Center, The Bronx, New York 10468 United States

Before you participate: Varda Clinical is an independent discovery tool, not the study sponsor or a medical provider. Eligibility can only be determined by the official study team. Discuss potential risks and benefits with a qualified healthcare professional.

Source: ClinicalTrials.gov. Record last refreshed by Varda Clinical: 2026-09-27.