After the Ozempic and GLP-1 drugs revolutionized the way diabetes and obesity are treated, the pharmaceutical industry is looking for what could be the next revolution. This time, the target is the brain and, more specifically, a natural substance that most of us have probably never heard of: orexin.
The Economist describes this new race with a telling headline: “The brain may be close to its Ozempic moment.”
But what is orexin?
Despite its name, orexin is not simply a substance related to appetite. It is a neuropeptide, a signaling molecule produced by a relatively small group of neurons in the hypothalamus, an area of the brain involved in controlling sleep, hunger, temperature, and many basic bodily functions.
Orexin functions as a type of biological wakefulness signal. When the system is active, it helps the brain maintain alertness, attention, and a stable state of wakefulness. It interacts with other brain systems that use dopamine, noradrenaline, serotonin, and histamine.
In very simple words: Orexin is one of the mechanisms that tells the brain to "stay awake."
Its importance was particularly understood from the study of narcolepsy. In most people with type 1 narcolepsy, the neurons that produce appetite are destroyed or almost gone. The brain thus loses part of the system that stabilizes the boundary between sleep and wakefulness.
The result is not just fatigue. Patients may fall asleep suddenly during the day and experience cataplexy, a sudden loss of muscle tone that is often triggered by strong emotions.
It was this discovery that gave the pharmaceutical industry an idea: if the disease is caused by the loss of the orexin signal, why not create a drug that mimics it?
This is what is happening now.
On August 5, 2026, the FDA approved Orzeyful, the trade name for oveporexton, developed by Takeda. It is the first orexin OX2 receptor agonist approved for adults with narcolepsy type 1.
Rather than simply stimulating the brain from the outside, as some traditional sleep-deprivation treatments do, oveporexton activates the receptor where orexin would normally act. So, in a way, the drug tries to replace the signal that the brain is missing.
In phase III studies, oveporexton significantly improved daytime sleepiness and cataplexy, as well as several measures of patients' daily functioning.
But here begins the part that makes the story interesting beyond narcolepsy.
What if orexin could also be used in people who don't have a deficiency?
Orexin doesn't just control sleep. Its system is also linked to attention, motivation, reward, mood, and metabolism. That's why pharmaceutical companies are trying to figure out whether drugs that activate orexin receptors could have much broader uses.
Takeda is developing other molecules in this class, while Alkermes is developing alixorexton, another oral OX2 receptor agonist, which has entered phase III studies for narcolepsy.
The potential of the orexin system in other neurological and psychiatric disorders is also being studied. For now, however, an important distinction must be made here: The biological potential is great, but for many of these uses, clinical evidence is still lacking.
And there is an interesting paradox.
The pharmaceutical industry has been using the same system for years to do exactly the opposite.
Insomnia drugs like suvorexant, lemborexant, and daridorexant block orexin receptors. If orexin is telling the brain to "stay awake," these drugs dampen that signal and help it transition to sleep.
New drugs do the opposite: They activate the receptor and strengthen the wake-up signal.
So, science is learning to use the same switch in both directions: To turn off the system when a person cannot sleep and to turn it on when the brain cannot stay awake.
This is where The Economist sees the analogy with Ozempic.
GLP-1 agonists started out as diabetes medications. Then their remarkable effect on weight was discovered, and today their use and study has expanded to a wide range of diseases.
The pharmaceutical industry's billion-dollar question is whether orexin could be the brain's GLP-1: A biological mechanism discovered for a relatively specific problem that then turns out to be useful in a much larger area of medicine.
It's still too early to know.
But a line has already been crossed. For the first time, there is a drug that directly targets the biological system that tells the brain when to stay awake.
And if the next generation of these drugs works beyond narcolepsy, the brain's "Ozempic moment" may not just be a good metaphor for a headline.
