Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA; Department of Chemical Engineering, University of Mississippi, University, MS 38677, USA.
Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA.
Adv Drug Deliv Rev. 2023 Jun;197:114824. doi: 10.1016/j.addr.2023.114824. Epub 2023 Apr 15.
Mental illnesses including anxiety disorders, autism spectrum disorder, post-traumatic stress disorder, schizophrenia, depression, and others exact an immense toll on the healthcare system and society at large. Depression alone impacts 21 million adults and costs over $200 billion annually in the United States. However, pharmaceutical strategies to treat mental illnesses are lagging behind drug development in many other disease areas. Because many of the shortcomings of therapeutics for mental illness relate to delivery problems, drug delivery technologies have the potential to radically improve the effectiveness of therapeutics for these diseases. This review describes the current pharmacotherapeutic approaches to treating mental illnesses as well as drug delivery approaches that have improved existing therapies. Approaches to improve drug bioavailability, provide controlled release of therapeutics, and enable drug targeting to the central nervous system (CNS) will be highlighted. Moreover, next-generation delivery approaches such as environmentally-controlled release and interval/sequential drug release will be addressed. Based on the evolving landscape of the treatment of mental illnesses, the nascent field of drug delivery in mental health has tremendous potential for growth in terms of both economic and patient impact.
精神疾病包括焦虑症、自闭症谱系障碍、创伤后应激障碍、精神分裂症、抑郁症等，给医疗系统和整个社会带来了巨大的负担。仅抑郁症在美国就影响着 2100 万成年人，每年造成的医疗费用超过 2000 亿美元。然而，治疗精神疾病的药物策略远远落后于许多其他疾病领域的药物研发。由于精神疾病治疗的许多缺陷与给药问题有关，因此药物输送技术有可能从根本上提高这些疾病的治疗效果。这篇综述描述了目前治疗精神疾病的药物治疗方法，以及改善现有治疗方法的药物输送方法。将重点介绍提高药物生物利用度、提供治疗药物的控制释放以及实现药物靶向中枢神经系统（CNS）的方法。此外，还将涉及下一代输送方法，如环境控制释放和间隔/顺序药物释放。基于精神疾病治疗领域的不断发展，精神健康领域的药物输送这一新兴领域在经济和患者影响方面都有巨大的增长潜力。
