2008年8月25日

New Antidepressant Developments and Approvals

 

New antidepressant development, until fairly recently, was at best a random, and at worst a problematic and frustrating, process. Often, medications that were developed for one thing were discovered quite accidentally to have much more important therapeutic effects for a completely different disorder. It has been well described that some of the original antipsychotics were originally developed to assist in anesthesia, and some of the original new antidepressants were originally intended to be medications for tuberculosis or psychosis. New antidepressant development was done on a "chemical" basis; that is, guesses were made as to compounds that would be safe and effective based on chemical structures of established medications. This was very much a trial-and-error process, since very little was known about how these drugs worked and very little could be measured beyond actually giving them to a patient.
New antidepressant development always has been and always will be a partnership between efficacy (ie, whether the drug is effective) and safety (ie, whether the drug can be tolerated by a patient). There were very few ways of knowing the answers to those two questions about any given compound unless you tried it, a process not without its obvious risks. It should be noted that vagus nerve stimulation for depression clearly meets the two main FDA requirements of safety and efficacy.
Medications to treat depression; mild, severe, bipolar, or treatment-resistant, make the news most frequently, and deservedly so. Their progress and approval can potentially benefit almost 8 million Americans who suffer from some form of depression. Because there seems to be more frequency now of depression that is treatment-resistant, meaning most methods of treatment (medications, psychotherapy, electroconvulsive therapy, or a combination of more than one treatment) have failed for a patient, the approval of new antidepressants from companies like Merck, Lilly, and Pfizer

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