The brain may be about to have its Ozempic moment

The brain may be poised for a transformative moment, akin to the rise of Ozempic, according to recent developments in pharmaceutical research. Glucagon-like peptide-1 (GLP-1), a hormone released by the gut after a meal, has been a game-changer in medicine, initially used for diabetes treatment and later proving beneficial for weight loss and various other ailments.

Now, scientists are exploring the potential of orexins, a pair of neurotransmitters that regulate wakefulness, to bring about similar advancements in the field of brain-related disorders. Orexins are produced by specialized neurons located in the hypothalamus, a brain region behind the eyes. When released, they bind to two types of cell-surface receptors, OX1R and OX2R, in neighboring neurons, activating multiple wakefulness-promoting systems.

Currently, there is one orexin agonist, oveporexton, approved by the FDA for narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and sudden sleep attacks. Alkermes, an Irish biotech, is developing a competing drug, and Eli Lilly, which has benefited from GLP-1 successes, is acquiring a biotech with an orexin drug in early trials for an estimated $7.8 billion.

Morgan Stanley estimates that orexin medicines could generate $16 billion annually by 2035, primarily from narcolepsy and related sleep disorders, which afflict approximately one in 2,000 people in the United States. However, the potential applications of orexin medicines extend beyond narcolepsy, with drugmakers hoping they could eventually treat depression, ADHD, and addiction, affecting hundreds of millions of individuals globally.

The discovery of orexins dates back nearly three decades, with two independent research teams identifying and naming the peptides hypocretins in 1998.