Failed Allergan Antidepressant May Find New Life in Treating Opioid Withdrawal
In early March, Allergan reported that rapastinel, its experimental adjunctive treatment for major depressive disorder, failed to hit endpoints in a late-stage trial. The medication may not have seen its last legs, though. A new study suggests it can benefit patients going through opioid withdrawal.
In an animal study, rapastinel has shown some significant ability in this area. After three days of treatment, research has shown that rapastinel substantially reversed acute signs of opioid withdrawal in rats. While rapastinel may not have hit the mark as an antidepressant medication, it could find new life to benefit a significant health issue in the United States. The findings of the animal study suggest that rapastinel, a modest and selective positive NMDA receptor, that the medication could benefit patients during those crucial first few days when someone has entered treatment for opioid abuse.
A Villanova University undergraduate conducted the research study alongside Cynthia M. Kuhn, a professor of pharmacology and cancer biology at Duke University. The student, Julia Ferrante, said the early research shows that rapastinel has potential as a new treatment for opioid dependence. Kuhn said the results of the animal study shows rapastinel is “effective in reducing withdrawal signs and has not been shown to produce any negative side effects,” Ferrante said in a statement.
“By reducing withdrawal symptoms, the patient feels less discomfort during treatment, and we hypothesize this would lead to a decreased risk of relapse,” Ferrante said. “Our research suggests that new alternatives to standard treatments for opioid dependence have potential to be safer and more effective.”
The study tested the efficacy of rapastinel, ketamine or a saline solution in the rat subjects. On the third day, rats given rapastinel showed significantly fewer signs of withdrawal than rats given either ketamine or saline, which showed roughly equal amounts of withdrawal signs, the researchers said.
Data from the opioid withdrawal study was presented Sunday at the American Society for Pharmacology and Experimental Therapeutics annual meeting during the 2019 Experimental Biology meeting. Ferrante said that there is hope rapastinel could move into human trials as a potential treatment for opioid withdrawal.
With the opioid epidemic continuing to task healthcare systems across the United States, combatting the issue has become a high priority for the U.S. Food and Drug Administration. The most common drugs used to help patients overcome opioid abuse are buprenorphine and methadone. Those drugs are effective, but have some side effects. Last year, the regulatory agency proved Kentucky-based US WorldMeds Lucemyra (lofexidine hydrochloride) for the mitigation of opioid withdrawal symptoms in adults. Lucemyra, an oral, selective alpha 2-adrenergic receptor agonist, became the first approved non-opioid treatment to manage withdrawal symptoms.
Ferrante noted that Ketamine has also been proposed as a potential treatment to help withdrawal symptoms but added that the drug, which has been used as a party drug, as well as a treatment for postpartum depression, also has potential for abuse. Rapastinel binds to the same receptor as ketamine but has a milder effect, Ferrante said.
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