Rejected Depression Drug Could Provide Relief For Opioid Withdrawal

By Kelly Burch 04/10/19

A rejected depression drug is being reexamined as a potential non-addictive treatment for opioid withdrawal symptoms. 

doctor passing depression drug to another doctor

A drug that was developed to treat depression but was ultimately shown in clinical trials to be ineffective could have a new purpose: helping people overcome withdrawal symptoms when they stop using opioids. 

The drug, rapastinel, binds to the same receptors as ketamine, NMDA receptors, and was being explored as a treatment for depression, similar to the newly-approved esketamine. However, in March, clinical trials showed that rapastinel was not effective in alleviating depression symptoms. 

Yet, researchers found that in rats, rapastinel provided relief from opioid withdrawal symptoms, according to a press release. The findings were presented at the 2019 Experimental Biology Meeting of the American Society for Pharmacology and Experimental Therapeutics, held April 6-9 in Orlando. 

Researchers Julia Ferrante, an undergraduate at Villanova University, and Cynthia M. Kuhn, a professor of pharmacology and cancer biology at Duke University, say that rapastinel could serve as a non-addictive medication to treat opioid withdrawal symptoms. 

"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," Ferrante said. "By reducing withdrawal symptoms, the patient feels less discomfort during treatment, and we hypothesize this would lead to a decreased risk of relapse.”

Currently, buprenorphine and methadone are used to manage symptoms of opioid withdrawal, but since both are opioids they are problematic for people with opioid use disorder. Ketamine has been explored as a possible way to manage withdrawal symptoms, but it also has the possibility for abuse, and can cause hallucinations that are particularly problematic for people with underlying mental health issues. 

During the research, rats with opioid dependence were given saline, ketamine, or rapastinel. Those given rapastinel showed the fewest withdrawal symptoms. With that data in mind, Ferrante said that in humans rapastinel could potentially be delivered intravenously in an outpatient setting, in order to help people through the painful opioid withdrawal process. 

"Our research suggests that new alternatives to standard treatments for opioid dependence have potential to be safer and more effective," Ferrante said. 

Unfortunately, that goal may be a long way off, since additional research is needed before rapastinel could even begin human trials. 

“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,” Ferrante said. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.