A Critical View on New and Future Antidepressants.

After many decades, many new antidepressants have been approved and more are in development, offering faster action, better tolerability, and broader treatable disorders. Neurosteroids provide rapid benefits for postpartum, anxious, and bipolar depression. Dextromethorphan and bupropion combination may help major and treatment-resistant depression. Dextromethadone may augment partial antidepressant response. Psychedelic drugs can produce long-lasting benefits after a single administration but remain experimental. Botulinum also offers single-administration antidepressant effects lasting weeks or more. Other promising mechanisms include new drug targets, drug repurposing, and genetic or epigenetic manipulations. Clinicians need updated evidence to translate new findings into practice.

Study at a glance

Abstract

For the first time after many decades, many new antidepressants have been approved and many more are under various stages of development and will soon be available in the market. The new drugs present a range of new mechanisms of action with benefits in terms of speed of action, tolerability and range of treatable disorders. Neurosteroids have been recently approved and their rapid benefit may extend from postpartum depression to anxious depression and bipolar depression, dextromethorphan and bupropion combination may prove useful in major depression but also in treatment resistant depression, dextromethadone is a possible augmentation in partial antidepressant response, psychedelic drugs have the potential of long lasting benefits after a single administration, though are still experimental treatments. Botulinum has the same advantage of psychedelics of a single administration and its antidepressant effects may last for weeks or more. Further potentially interesting new antidepressant mechanisms include new drug targets, drug repurposing and genetic or epigenetic manipulations. It is therefore important that clinicians are kept up to date with new evidence so that new evidence can be rapidly translated into clinical practice.