Post Traumatic Stress Disorder
PTSD is a disorder that some people develop after experiencing a shocking, scary or dangerous event. It is estimated that approximately 8 million Americans, or 3.5% of the population, suffer from PTSD at any given time1. For veterans of the Vietnam War, the prevalence was estimated to ~30%, whereas estimates for veterans from recent wars (Gulf war, Operation Iraqi Freedom) range from 11-20%1.
The disorder is thought to result from an imbalance between excitatory and inhibitory brain neurocircuitry, and treatments typically include psychotherapy and/or medication. There is no clinical evidence, however, that these treatments help. Thus, there is a significant unmet medical need for new therapeutics and the PTSD market is projected to reach $1.7 billion by 2019 2.
Opioid use disorders
Opioids are prescribed to treat acute and chronic pain. With prolonged use, opioid tolerance develops and this reduces the pain mitigating effect of the drug. Furthermore, extended use leads to addiction and dependence in 8-12% of patients 3, which is one of the reasons for the global epidemic of opioid abuse. It has been estimated that 26-36 million people abuse opioids worldwide, and in 2015, more than 30,000 Americans died as a result of opioid overdose, including prescription opioids, heroin and illicitly manufactured fentanyl3. These numbers underscore the significant unmet medical need for non-addictive, safe alternatives to opioids. The global opioid market size was estimated to $34.8 billion in 2015 4.
In developed countries, 5-10% of the population undergoes surgery every year and in the US alone, ~35 million inpatient surgeries are carried out annually. However, in only 25% of these patients is the postsurgical pain managed satisfactorily, with the majority of patients reporting moderate to severe pain 5. Furthermore, for 1 in 5 of the patients, the pain becomes chronic requiring prolonged management. Accordingly, there is a significant unmet medical need, and optimal pain management during and after surgery is critical to patient recovery, morbidity and cost. Typically, single analgesics are unable to provide effective pain relief for moderate or severe pain, and for decades, the same two drug classes have been used in postoperative pain management: Opiate analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Both drug classes have undesired side effects, including respiratory depression, constipation, vomiting, nausea, bleeding and sedation. Importantly, opiates are highly addictive, which has contributed to a global epidemic of abuse. In 2010, the post-operative pain relief market was estimated to $5.9 billion 6.