Depressive Disorders-Recent medication treatment approaches D F Ionescu

Depression is one of the most common psychiatric conditions. Symptoms can lead to significant disability, which result in impairments in overall quality of life. Though there are many approved antidepressant treatments for depression—including selective serotonin reuptake inhibitors, tricyclic antidepressants and monoamine oxidase inhibitors—about a third of patients do not respond to these medications. Therefore, it is imperative for drug discovery to continue towards the development of novel and rapidly acting compounds, especially for patients with treatment-resistant depression. After a brief review of the efficacy of approved antidepressant therapies, we will discuss experimental medication treatments for depression. Specifically, we examine novel medications that are thought to primarily modulate the glutamatergic, cholinergic and opioid systems to achieve antidepressant efficacy. We also give examples of anti-inflammatories, neurokinin-1 modulators, vasopressin antagonists and neurogenesis enhancers that may have a therapeutic role in treatment-resistant depression. The current pipeline of antidepressant treatments is shifting towards medications with novel mechanisms, which may lead to important, life-changing discoveries for patients with severe disease.

Treatment-resistant depression costs nearly $50 billion annually

STAR*D—the largest comparison trial-a cumulative 67% response rate after all four steps of the study for antidepressant treated group.Gibbons et al. found an estimated response rate of 58.4% (versus 39.9% for placebo) to antidepressants

Medications  trials-

Ketamine,Riluzole,Lanicemine (AZD 6765) of Astrazeneca,Memantine,Traxoprodil (CP-101,606),CERC-301 (MK-0657),

Metabotropic glutamate receptor modulators like a mGluR5 receptor antagonist, and decoglurant (RG1578 or RO4995819)—a mGluR2/3 antagonist,Rapastinel (GLYX-13),AVP-786 (dextromethorphan/quinidine),AXS-05 (dextromethorphan/bupropion),

Opioid modulators like AZD2327,ALKS 5461 (buprenorphine/samidorphan),

Cholinergic modulators like Scopolamine,CP-601,927,

Anti-inflammatory agents like Sirukamab,

Neurokinin-1 antagonists like Aprepitant, casopitant and orvepitant (GW823296),

Vasopressin antagonists like Nelivaptan (SSR149415),

Neurogenesis enhancers like NSI-189


Experimental medication treatment approaches for depression

  • Translational Psychiatry (2017) 7, e1068 (2017)
  • doi:10.1038/tp.2017.33
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