In early August 2026, the U.S. regulator the FDA approved o?veporex?ton (Orzeyful) from Takeda — the first-ever drug that treats pathological sleepiness, type 1 narcolepsy, not just its symptoms but its cause. Analysts at Morgan Stanley estimate that the potential market for such drugs will grow to $16 billion by 2035, The Economist reports. However, the potential applications for drugs of this kind are much broader: scientists hope they can also help treat other sleep disorders, as well as common conditions such as attention deficit hyperactivity disorder (ADHD) and depression. Potentially, this could be a breakthrough comparable to the discovery of weight-loss drugs based on GLP-1, such as Ozempic. Who should we watch in this race?
The sleep mystery
We spend about a third of our lives asleep, yet the principles of how this mechanism works are still largely a mystery. People guessed the power of sleep long before the rise of neuroscience. As Aristotle wrote back in the treatise “On Sleep and Waking,” sleep is a natural consequence of perception because the sensory organs need periodic rest. And Hippocrates and his students believed sleep was necessary to maintain human health. Interpretation of dreams was also used as a tool for diagnosing and treating conditions caused by internal sensations.
Modern science agrees on the importance of sleep; however, only in 1953, when the “rapid eye movement” phase—during which we see dreams—was discovered, did it become clear: the sleeping brain is not turned off, it’s simply switched to another mode.
Disruptions to this routine are the most widespread and, at the same time, the most “invisible” medical problem. On one side is insomnia, which nearly every fourth adult in the world faces. On the other side is its mirror opposite: narcolepsy, when a person suddenly falls asleep during the day and sometimes at the most inappropriate moment. Sometimes it’s also accompanied by cataplexy—sudden “shutdown” of the body’s muscles. The patient might laugh at a joke—and then suddenly fall to the floor because their muscles give out. This mechanism (one of many in the complex regulation of sleep and wakefulness) allows you not to pound your husband/wife at full strength at night if you dreamed that you, for example, were fighting off a leopard. But in some people it switches on during the day, and for a long time it was unclear what causes it.
Dog joy
The answer came from where nobody expected—dogs. As described in a review in Frontiers in Neuroscience, in the 1970s in Stanford they kept a colony of dogs with hereditary narcolepsy: the dogs would fall asleep from sheer joy at the sight of food, literally toppling over. Young French neurobiologist Emmanuel Minyo came to California to study these dogs. A sweet detail: he still keeps at home a narcoleptic Chihuahua named Watson from that very colony, writes The Wall Street Journal. For ten years he searched for the cause behind the disease and in the end discovered that people with type 1 narcolepsy (NT1) simply don’t have neurons in their brains that produce one small peptide—orexin (also known as hypocretin).
However, understanding the cause of the illness is one thing, while finding a cure for it is something completely different.
Japanese pharma company Takeda spent fifteen years searching before it created ooverexinton. The drug has side effects—insomnia and increased urination in about a third of patients—but they turned out to be tolerable: more than 95% of patients who completed the study agreed to continue taking the drug, Nature writes.
Nineteen-year-old Tyler Chapman from Tennessee slept 16 hours a day, tried 13 different medications, and drank the equivalent of 10 cups of coffee a day. Then he became a volunteer in a clinical trial of a new drug—and only a few minutes after taking the tablet, as he told WSJ himself, “my body was like plugged into an outlet— for the first time in ten years I felt alive.”
The objective results are also impressive. Patients with NT1 were offered a wakefulness-maintenance test: sit in a dark, quiet room and do not fall asleep. A healthy person can last 30–35 minutes. An NT1 patient—about 4 minutes. After 12 weeks of taking ooverexinton, the average sleep latency increased from 4 to 20 minutes—meaning patients returned to practically the normal range. Cataplexy attacks decreased by about threefold. Minyo, who led the final Takeda studies at Stanford, calls it “a full revolution: the first dose is like turning on the light in the room.”
Old narcolepsy drugs—stimulants such as modafinil or amphetamines—boosted certain neurotransmitters (dopamine, norepinephrine), which improved alertness but could cause anxiety, raised blood pressure, and a risk of dependence. Ooverexinton works like an “orchestra conductor,” coordinating multiple wakefulness systems at once, The Economist explains. Instead of tugging just one string separately, the drug restores the orchestra’s synchronized performance. Hence the lower potential for misuse.
The game begins
Narcolepsy type 1 by itself is a fairly rare disease. Takeda’s estimate for the United States is about 60,000 diagnosed patients and roughly the same number again who are not diagnosed. But the brain’s orexin receptors are responsible not only for sleep: they also regulate the reward and motivation system, attention, and overall tone. Hence the appetite of pharma companies.
The first obvious target outside narcolepsy is ADHD. According to a psychiatrist and researcher from Columbia University (USA), Ryan Sultan, about 366 million adults worldwide have this condition—and 85% of them are not even diagnosed. There are still about 47 million children and adolescents under 20, and that number applies only to those who have already been diagnosed. The current ADHD drug market is $17 billion per year, with prospects to grow to $24 billion by 2030, estimates The Business Research Company.
If we look broader—in fact, all sleep disorders, including insomnia—the scale becomes even more impressive. A systematic review published in 2025 in Sleep Medicine Reviews estimated the global prevalence of clinical insomnia: 852 million adults, or 16.2% of the world’s population, plus another 415 million with a severe form. The overall market for medications for sleep disorders is estimated at $33 billion and is expected to grow by 14% per year, reaching $65 billion by 2030. Narcolepsy, with its current $3 billion market, is not even the tip of the iceberg. Now it’s clear why the CEO of the orexin startup Centessa, Mario Aghcardi, directly calls this class “GLP-1 neuroscience.” The market for GLP-1-based diabetes and obesity drugs is, by the way, estimated at $80 billion, with a forecast to grow to $185 billion by 2033.
The race is already on. In March 2026, Eli Lilly announced it would buy Centessa Pharmaceuticals for $6.3 billion (including possible additional payments—up to $7.8 billion) for ceminorexinton, orexin for different types of narcolepsy, which is already in the final Phase III of clinical trials.
Alkermes, with its drug alicorexinton for treating all types of narcolepsy, is also already in Phase III, and in Phase I it is testing promising molecules for treating ADHD.
Altogether, according to Nature, there are currently 11 orexin-based drugs at various stages of clinical trials, and this, obviously, is only the beginning.
Right now Takeda leads, but as we know, the pioneer doesn’t always reap the profits. Novo Nordisk was the first to bring GLP-1-based diabetes and obesity drugs to the market, and the same Ozempic made the Danish company legendary. However, today the lion’s share is taken by Eli Lilly—its share in the US is 61%, versus 39% for Novo, CNBC reports.
The orexin story could repeat itself: Takeda wrote its name into the history books, but Lilly—with its $7.8 billion bet on Centessa and broader indications—could quite possibly take the lead. Or it could be someone else we don’t know about yet—in any case, the orexin story is the plot the whole world will watch with great interest. And with hope, finally, to get out of depression and sleep normally.
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