What could easily be the most important advance in the pharmacologic treatment of major depression and anxiety disorders is now unfolding.
A new investigational drug, currently known as ALKS 5461, could deliver all the mood-enhancing and anxiety-lowering effects that lead people to use opiates like heroin and Oxycontin—without the potential for getting high or addicted. That’s right: ALKS 5461 could be a non-abusable, non-addictive heroin-like compound.
ALKS 5461 is actually a combination of two molecules. The first is buprenorphine, which is already used to provide some of the benefits of opiates, without many of the worst side effects, allowing people to get off of street drugs (as an alternative to methadone). The second molecule is now known as ALKS 33—and that’s the magic part.
ALKS 33 interferes with the binding of buprenorphine to the receptors that are involved in making people feel euphoric. Those are the receptors also involved in getting people to crave opiates like alcoholics crave alcohol.
In a double-blind, placebo controlled study (meaning, the participants had no idea whether they were getting ALKS 5461 or a sugar pill), ALKS 5461 was rapidly effective in relieving symptoms in 32 patients with major depression. All 32 patients responded to the medicine—with results evident by seven days.
What’s more, all of them had failed to respond adequately to traditional antidepressants like Prozac or Effexor.
Ultimately, I believe ALKS 5461 could revolutionize the pharmacologic treatment of major depression and panic disorder and post-traumatic stress disorder and obsessive-compulsive disorder.
It should come as no surprise that ALKS 5461 is the brainchild of scientists at Alkermes Pharmaceuticals, the same company, which invented and markets Vivitrol, a monthly injection that can take away the “high” of using alcohol and street drugs—and in my opinion, ought to be something that every family member of every addict clamors to get their loved one to take.
If ALKS 5461 comes to market (and I believe it will), then that scourge we call major depression will be dealt a massive blow. It will still be imperative to use insight-oriented psychotherapy to get to the bottom of what unique psychological issues have fueled each person’s depression, but that should be easier—not harder—when folks aren’t struggling just to get out of bed and over to their psychiatrists’ offices.
This is a really big deal.
Keith Ablow, MD is a psychiatrist, and was host of the nationally-syndicated "Dr. Keith Ablow Show." He is a former member of the Fox News Medical A Team.