Addiction and Anxiety Reviewed

The May/June 2018 issue of NeuroPerspective  takes NP into a world of internal contradictions, in an issue that features reviews of Addiction and Anxiety. Addiction, in view of the American ‘Opioid Epidemic’, receives enormous press coverage in the US, but a relatively paltry slice of the federal funding pie, and a pathetically infinitesimal portion of pharma’s R&D outlays. There is a surfeit of hand-wringing and blame-placing, but  little more than window-dressing when it comes to putting actual resources to work. NIDA has done exemplary work in keeping the lights on for Addictions research, but hardly at the scale necessary given the scope of the disorder. Crowd-funding Narcan is not a strategy, it is a illustration of individuals trying to compensate for societal negligence.This is the first time that NIR has reviewed the field of Addiction since the November/December 2015 issue, and during that time, the  ‘Opioid Epidemic’ in America has finally percolated into public awareness. In so doing, it has moved opioid addiction from its former subsistence at the murky margins of contemporary society right to the core, reflecting the decimation of neighborhoods and families across the full spectrum of socioeconomic strata. This review details the neurophysiology and therapeutic approaches to opioid addiction, and  its substance abuse siblings: Alcohol, Nicotine, and Stimulants (cocaine and methamphetamine). Therapeutic programs from Addex, Braeburn, Embera, Indivior, MediciNova, Opiant, and Savant are among those reviewed in the review.

Anxiety is similarly underaddressed given its prevalence: The number of individuals in the US, EU, and Japan with anxiety disorders is in the many tens of millions.  The reality is that the majority of those with anxiety disorders suffer through them, because the available treatment options are either inadequate (pharmacotherapy) or under-funded by payors (psychotherapy). And the pharma industry? There is hardly any Big Pharma activity in pursuit of anxiolysis, and not much more than that from small biotech/biopharm companies. Programs from Addex, Aptinyx, Azevan, Bionomics, Idorsia, JNJ, Marinus, and SpringWorks are among those covered, with this work at times overlapping with the work on PTSD therapeutics covered in the March/April issue.

The May/June issue also discusses Biohaven’s rimegepant results; Alkermes and the FDA; and the ‘Billions’ invested by Novartis and Biogen in AveXis and Ionis. Company reviews for Opiant and Bionomics are included.