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2008/9 Catalogue
Library Recommendation
Summary
February 2007, Vol. 7, No. 2, Pages 203-213 , DOI 10.1586/14737175.7.2.203
(doi:10.1586/14737175.7.2.203)

Review
Emerging treatments for major depression
Trevor R Norman and Graham D Burrows
Author for correspondence



Antidepressant drugs were introduced into clinical practice in the mid-20th Century. While for the most part they have proven effective for the amelioration of depressive symptoms, they are associated with significant deficiencies. These well-recognized shortcomings have given impetus to the pursuit of new molecules that seek to improve on the efficacy, tolerability and safety of existing medications. The following article reviews several new compounds that may have antidepressant potential. Some are more advanced in development, having undergone clinical trials, whereas the clinical potential of others is yet to be explored. For this latter group of compounds, the antidepressant potential relies on their activity in validated animal models. Agomelatine and duloxetine are in the first category, having shown antidepressant efficacy in clinical trials. The blockade of cortisol secretion continues to be a focus of attention for the development of new antidepressants. Thus, synthesis inhibitors, nonpeptide antagonists of corticotropin-releasing factor and glucocorticoid receptor antagonists show some promise in clinical and preclinical tests. Antagonists of the neuropeptide substance P, vasopressin and neuropeptide Y represent a departure of approach from traditional monoamine receptor-based mechanisms. While the clinical results with one substance P antagonist have led to the cessation of further trials, other molecules are in development. Approaches to treatment based on glutamatergic transmission arose from observations in animal models. The clinical evaluation of such compounds awaits further development. The extent to which new agents can be judged to have met the goals of efficacy, tolerability and safety rely not only acute treatment trials but also on longer-term outcomes and postmarketing surveillance. Whether any of the new agents canvassed here prove to be significantly better than existing agents is clearly a judgement for the future.

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Cited by

Ling Li, Xiaoya Gao, Jia Zhao, Xunming Ji, Huan Wei, Yumin Luo. (2009) Plasma and cerebrospinal fluid substance P in post-stroke patients with depression. Psychiatry and Clinical Neurosciences 63:3, 298-304
Online publication date: 1-Jul-2009.
CrossRef
Kenneth J. Sufka, Jason E. Warnick, Cassan N. Pulaski, Stephen R. Slauson, Young B. Kim, John M. Rimoldi. (2009) Antidepressant efficacy screening of novel targets in the chick anxiety-depression model. Behavioural Pharmacology 20:2, 146-154
Online publication date: 1-Apr-2009.
CrossRef

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Authors:
Trevor R Norman
Graham D Burrows
Keywords:
agomelatine
cortisol
duloxetine
glucocorticoid receptor
glutamatergic receptor
HPA axis
neuropeptide
neurotropic hypothesis
substance P


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