Zhang Yuan-Wei, Cheng Yung-Chi
School of Life Sciences, Guangzhou University, Guangzhou, China.
Department of Pharmacology, School of Medicine, Yale University, New Haven, CT, United States.
Front Neurosci. 2019 Mar 5;13:190. doi: 10.3389/fnins.2019.00190. eCollection 2019.
Current medication for depression is inadequate and far from ideal. Development of novel antidepressant drugs is a pressing task. The discovery of ketamine and related agents represents a new era in drug discovery for the rapid treatment of depression. Due to potential neurotoxicity, short-lasting efficacy, the limitation of a single target approach, and a limited role in depression prevention of these agents, additional approaches or drugs that exert synergy and compatibility, with the rapid-acting agents are required for better treatment of depression. Traditional Chinese Medicine (TCM) is a systems medicine and its clinical experience and integrated theory for diagnosis and treatment provides an alternative method of novel drug discovery in depression treatment. In TCM, there are numerous claimed effective antidepressant formulas, but comprehensive research and evidence-based clinical studies are required for their acceptance as a treatment. In this essay, we review current attempts in the discovery of new agents, TCM drug formulation, and TCM treatment of depression, and discuss the challenges and opportunities of TCM in the new era of antidepressant discovery. TCM could provide an important resource in the discovery of novel agents, assistance of the rapid-acting antidepressants, development of new agents for female patients, and the prevention of depression at its early stages. The study of depression in conjunction with TCM therefore not only provides an opportunity to scientifically evaluate the benefits and risks of TCM, but also accelerates the development of novel antidepressant agents by combining the principle of modern molecular medicine with the ideas of empirical systems medicine.
目前用于治疗抑郁症的药物并不充分，远非理想。开发新型抗抑郁药物是一项紧迫的任务。氯胺酮及相关药物的发现代表了药物研发领域的一个新时代，用于快速治疗抑郁症。由于这些药物存在潜在的神经毒性、疗效持续时间短、单一靶点方法的局限性以及在预防抑郁症方面作用有限，因此需要额外的方法或药物来与速效药物发挥协同作用并相互兼容，以更好地治疗抑郁症。中医是一种系统医学，其临床经验以及诊断和治疗的综合理论为抑郁症治疗中的新药研发提供了一种替代方法。中医中有许多声称有效的抗抑郁方剂，但要使其被接受作为一种治疗方法，还需要进行全面研究和基于证据的临床研究。在本文中，我们回顾了当前在发现新药物、中药方剂以及中医治疗抑郁症方面的尝试，并讨论了中医在抗抑郁药物研发新时代所面临的挑战和机遇。中医可以在发现新型药物、辅助速效抗抑郁药物、为女性患者开发新药以及早期预防抑郁症方面提供重要资源。因此，结合中医对抑郁症进行研究不仅为科学评估中医的益处和风险提供了机会，还通过将现代分子医学原理与经验系统医学理念相结合，加速了新型抗抑郁药物的研发。
