A
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drug that scientists originally developed to
treat depression may have promise for the treatment of opioid withdrawal,
researchers say.
A
new experimental drug may help reduce opioid withdrawal symptoms.
Opioid
withdrawal is a challenging experience, and although there are medications
already on the market that can help curb the symptoms of withdrawal, these
drugs cause negative side effects.
Current
withdrawal medications also often require people to take them for a prolonged
period, which is not ideal and could lead to a relapse.
There
may be encouraging news on the horizon, however. New research highlights the
possible benefits of an experimental drug called rapastinel, which
scientists initially created to help those with major depressive
disorder.
This
new research showed that rats responded positively to rapastinel in opioid
withdrawal studies. The researchers noted that rapastinel had a significant
effect on withdrawal in just a few days, which could make it a candidate for
future testing in human participants in a clinical setting.
The
first few days after halting opioid use can be very difficult because the
withdrawal symptoms can be exceptionally severe. This stage is when rapastinel
could potentially be useful, as it may help ease those symptoms without the
additional burden of side effects. It could also reduce the need for
prescription drugs that require long-term use for a person to avoid relapse.
"We
have found that rapastinel has potential as a new treatment for opioid
dependence, as it is effective in reducing withdrawal signs and has not been
shown to produce any negative side effects," notes Julia Ferrante, an
undergraduate at Villanova University in Pennsylvania.
Ferrante
conducted the research with Cynthia M. Kuhn, Ph.D., a professor of pharmacology
and cancer biology at Duke University in Durham, NC. The findings
featured at the American
Society for Pharmacology and Experimental Therapeutics annual
meeting, which took place recently during the Experimental
Biology 2019 meeting in Orlando, FL.
Opioid addiction and withdrawal
Opioid use
disorder is a chronic condition that can significantly affect a
person's health, job, and financial situation. While doctors prescribe opioids
in cases of severe, postsurgical, or chronic pain, they are also often
accessible on the black market.
Legal
opioids include oxycodone, oxymorphone, hydrocodone, codeine, morphine,
fentanyl, and buprenorphine. Heroin, an illegal drug, is another example of an
opioid.
In
some cases, opioid use can lead to addiction. These drugs can also cause severe
health problems and sometimes even result in overdose and loss of life.
According to estimates, the misuse of prescription opioid medications and
heroin affects more than 2 million people in the United States every
year.
Physical
and psychological dependence present a new set of problems when the person
ceases taking the drug. During withdrawal, symptoms include
nausea, vomiting, anxiety, insomnia, hot or cold
flashes, sweating, cramps, and gastrointestinal upset.
People
commonly take methadone or buprenorphine to alleviate some of these symptoms,
but these drugs are also opioids and can be addictive. They also have side
effects of their own and can often only prevent a relapse if people use them
for an extended period.
Rapastinel as a withdrawal treatment
Recent
clinical trials found that rapastinel is not effective for depression, but they did
reveal that people can tolerate the medication well and that it does not cause
significant side effects.
The new research involving rats going through
withdrawal showed that the rodents that received rapastinel had far fewer
withdrawal signs than those that the researchers gave either ketamine or a
saline solution.
While
these results are promising, it will take some time before rapastinel reaches
clinical trials in humans. Until then, researchers will conduct more studies to
determine how rapastinel works on a molecular level and how it might work to
prevent relapse.
"By
reducing withdrawal symptoms, the patient feels less discomfort during
treatment, and we hypothesize this would lead to a decreased risk of
relapse," says Ferrante.
"Rapastinel research for opioid
dependency is currently only being done in rodents, but if the drug continues
to have successful trials, it may enter clinical trials for use in
humans."
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