Meperidine
| 證據等級: L5 | 預測適應症: 2 個 |
目錄
Meperidine: From Pain Management to Tourette Syndrome
One-Sentence Summary
Meperidine (pethidine, DrugBank DB00454) is an opioid analgesic historically used for moderate-to-severe pain. The TxGNN model predicts potential efficacy for Tourette Syndrome, but this prediction is currently supported by 0 clinical trials and 0 publications — it reflects a knowledge-graph statistical association only, with no direct mechanistic or clinical evidence.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not available from licensing data; based on known pharmacology, meperidine is an opioid analgesic used for moderate-to-severe pain |
| Predicted New Indication | Tourette Syndrome |
| TxGNN Prediction Score | 99.46% |
| Evidence Level | L5 (model prediction only, no supporting studies) |
| Taiwan Market Status | Not marketed (未上市) |
| Number of Licenses | 0 |
| Recommended Decision | Hold |
A second candidate, trichotillomania (score 99.39%, rank 13973), was also flagged with identical L5 evidence and a Hold recommendation — see note below.
Why is This Prediction Reasonable?
Detailed original mechanism-of-action data (DrugBank MOA field) is not available for this record. However, based on known pharmacology, meperidine is a mu-opioid receptor agonist that also has anticholinergic, local-anesthetic (sodium-channel blocking), NMDA-antagonist, and monoamine-reuptake-inhibiting activity.
For Tourette syndrome, the tic-related dysregulation of basal ganglia dopamine has led some researchers to propose an “endogenous opioid hypothesis” — but that hypothesis has primarily been tested with opioid antagonists (e.g., naltrexone), not agonists. Meperidine acts in the opposite pharmacological direction, so there is no mechanistic basis for expecting it to improve tic symptoms.
For trichotillomania, the prevailing pharmacological hypothesis similarly implicates opioid antagonists as reducing impulsive hair-pulling behavior by blocking opioid signaling in reward/impulse circuits. Meperidine, as an opioid agonist, runs counter to this hypothesis and could theoretically worsen rather than improve impulsive behavior.
In both cases, the high TxGNN score (>99%) reflects knowledge-graph relationship strength, not causal or mechanistic evidence, and the mechanistic direction available in the evidence pack argues against — rather than for — plausibility.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Taiwan Market Information
Meperidine currently holds no TFDA licenses and is not marketed in Taiwan (0 licenses on record).
Safety Considerations
Please refer to the package insert for safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: Both predicted indications (Tourette syndrome and trichotillomania) have zero clinical trial and literature support (L5, model prediction only), and the available mechanistic rationale suggests meperidine’s opioid-agonist activity runs counter to the opioid-antagonist hypotheses proposed for these conditions. The drug is also unmarketed in Taiwan with no TFDA safety data on file.
To proceed, the following is needed:
- Confirmed DrugBank/TFDA mechanism-of-action and labeling data (currently blocking per data gap DG001/DG002)
- Preclinical or case-level evidence testing meperidine specifically (not opioid antagonists) in tic or impulse-control disorders
- TFDA warnings/contraindications data before any safety evaluation (S1) can begin
- Reassessment if independent mechanistic or trial evidence emerges, given the current agonist-vs-antagonist directional conflict
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.