Drugmakers are betting that orexin peptides, chemicals regulating wakefulness, could follow the success path of GLP-1 drugs like Ozempic. On August 5th, 2026, America's drug regulator approved oveporexton, made by Japanese pharmaceutical firm Takeda, as the first orexin agonist for narcolepsy. Irish biotech Alkermes is developing a competitor.

In June 2026, Eli Lilly bought Centessa, a biotech with an orexin drug in early trials, in a deal worth up to $7.8bn, aiming to capture another peptide boom. Morgan Stanley, a bank, estimates orexin medicines could generate $16bn a year by 2035 from narcolepsy and related sleep disorders alone, compared to current drugs with annual sales of $3bn. Beyond narcolepsy, estimated to afflict one in 2,000 Americans, orexins coordinate sleep, attention, motivation and the brain's reward system.

Drugmakers hope these medicines could eventually treat depression, ADHD and addiction, conditions burdening hundreds of millions. Orexins were discovered in 1998 by Luis de Lecea at the Scripps Research Institute in La Jolla, California, and Yanagisawa Masashi of the University of Texas Southwestern Medical Centre in Dallas. Emmanuel Mignot of Stanford University linked orexin mutations to hereditary narcolepsy in dogs.

These neurons inhabit the hypothalamus, a brain region behind the eyes. Once released, orexins lock onto OX1R and OX2R receptors; OX2R is crucial for maintaining wakefulness, stimulating systems relying on norepinephrine, serotonin and dopamine. OX1R is more involved with reward and motivation.

Drugmakers first learned to turn the OX2R conductor off using orexin antagonists for insomnia since 2014.