Re-Purposing FDA-Approved Drugs for Opioid Use Disorder

Abstract

Objective

To investigate FDA-approved drugs prescribed for unrelated diseases or conditions that promote remission in subjects diagnosed with opioid use disorder (OUD).

Methods

This was a retrospective observational study utilizing the TriNetX electronic medical record data. Subjects between 18 and 65 years old were included in this study. First, a drug screen was employed to identify medications used for chronic illness that are associated with OUD remission. Based on Fisher’s exact test for significance, 28 of 101 medications were selected for further analysis. Positive (buprenorphine/methadone) and negative controls (benazepril) were included in the analysis. Medications were analyzed in the absence and presence of buprenorphine or methadone, two medications used to treat OUD, to identify the likelihood of OUD remission up to one year following the index event.

Results

We identify 8 medications (prazosin, propranolol, lithium carbonate, olanzapine, quetiapine, bupropion, citalopram, and escitalopram) that may be useful for increasing remission in OUD in the absence of buprenorphine or methadone. Additionally, our results identify psychiatric medications that when taken alongside buprenorphine and methadone improve remission rates.

Conclusion

These results provide medication options that may be useful in treating OUD as well as integrated therapies to treat comorbid mental illness.

Keywords:

• Opioid use disorder
• drug repurpose
• alternative treatment
• abstinence
• mental illness

Acknowledgements

The authors thank Julie Graziane, M.D. for her review of and edits to the manuscript. Access and support for the use of TriNetX was provided througha National Center for Advancing Translational Sciences Clinical andTranslational Science Award.

Author contributions

KP, DW, and NG performed the data collection and analysis. KP, DW, and NG wrote the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.