According to a preclinical study by Scripps Research, the anti-Insomnia Drug suvorexant (Belsomra®) may be a successful treatment for opioid use disorder.
The Scripps Research scientists discovered that suvorexant decreased prescription opioid intake and assisted in protecting against relapse in rats modelled for opioid use disorder (OUD) in the study, which was published April 27, 2023, in Frontiers in Pharmacology. The Insomnia Drug may be a viable treatment option for the millions of people who suffer from OUD if the results of human clinical trials are confirmed.
“Our results suggest that repurposing suvorexant could be a good strategy for reducing drug intake and blocking relapse in cases of prescription opioid abuse.”, says Rémi Martin-Fardon, PhD, study senior author, associate professor in the Department of Molecular Medicine at Scripps Research
Jessica Illenberger, PhD, a postdoctoral research associate in the Martin-Fardon lab, was the study’s primary author.
Increasing cases of opioid-related overdoses
More than two million people are thought to be affected by OUD in the United States alone, and 80,000 people succumb to opioid-related overdoses every year, contributing to an alarming drop in the average life expectancy of Americans. Methadone, buprenorphine, and naltrexone are available treatments for OUD, however the majority of patients relapse, necessitating the urgent need for improved therapies.
Suvorexant was created to block the function of both orexin-1 and orexin-2 brain-cell receptors, yet it is unclear how this helps OUD. These receptors and the orexin proteins that bind to them have mostly been investigated for their functions in regulating wakefulness, hunger, and general arousal and alertness. Orexin signalling, however, has also been shown to support the process of drug dependence during the past 20 years, raising the possibility that it could be a good target for therapies.
Suvorexant was the first medication to suppress the activity of both orexin receptors, and it was licenced by the U.S. Food & Drug Administration (FDA) in 2014 for the treatment of Insomnia Drug. Martin-Fardon and colleagues discovered that suvorexant decreased alcohol consumption and prevented relapse in a rat model of alcohol Opioid use Disorder in a study that was published earlier this year.
Will Suvorexant come to rescue?
Martin-Fardon and his team’s latest research focused on the potency and effectiveness of suvorexant in preventing relapse in OUD, particularly when it comes to the potent and widely abused prescription drug oxycodone.
Suvorexant is eliminated from the bloodstream in rats much more quickly than it is in humans, but the researchers discovered that giving oxycodone-dependent rats the maximum dose (20 mg/kg) of the Insomnia Drug 30 minutes before their oxycodone binge sessions resulted in significantly lower self-administration of the opioid during the first hour of each eight-hour session.
According to Martin-Fardon, the smaller effect in females was expected given that opioid dependency definitely had a greater impact on them than it did on males: They consumed more than twice as much oxycodone during their binges as men did, and female relapses were also considerably more severe.
“If you were to treat people, you would have to consider whether the same dose of suvorexant would work equally well for men and women,” Martin-Fardon adds.
Overall, the results indicate that suvorexant does have an effect against oxycodone intake during addiction and relapse behaviour after abstinence, he claims. As a result, it would be worthwhile to explore suvorexant in clinical trials with individuals who are oxycodone dependent.
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