The treatment of depression — searching for new ideas
Frontiers in Pharmacology – October 07, 2022
Source: OpenAlex
Summary
Many people with Major Depression find current medicine, largely from the 1960s, often fails patients. While monoaminergic drugs like Serotonin reuptake inhibitors are frontline pharmacology, and esketamine was approved in 2019, side effects are common. This pressing need in psychiatry drives neuroscience to explore novel antidepressant treatments. New drug studies, leveraging bioinformatics and understanding pathways like Tryptophan metabolism in brain disorders, are critical. Future pharmacology must refine treatment, exploring diverse targets, including promising avenues like psychedelics.
Abstract
Depression is a severe mental health problem that affects people regardless of social status or education, is associated with changes in mood and behavior, and can result in a suicide attempt. Therapy of depressive disorders is based mainly on drugs discovered in the 1960s and early 1970s. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are frontline pharmacological strategies for the medical treatment of depression. In addition, approved by FDA in 2019, esketamine [as nasal spray; N-methyl-D-aspartate (NMDA) receptors antagonist with additional effects on α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, L-type voltage-dependent calcium channel (L-VDCC), opioid receptors, and monoaminergic receptors] is an essential compound in suicide and drug-resistant depression. However, the treatment of depression is burdened with severe side effects, and in many cases, it is ineffective. An equally important issue is the choice of antidepressant therapy in people with comorbid somatic diseases, for example, due to possible interactions with the patient's other drugs. Therefore, there is a great need for new antidepressants with different mechanisms of action and the need to refine the search for new substances. The purpose of this review was to discuss new research directions and new trends that dominate laboratories worldwide. We have reviewed the literature to present new points on the pharmacological target of substances with antidepressant activity. In addition, we propose a new perspective on depressive therapies.