Karuna Therapeutics, Washington University School of Medicine, St. Louis, MO, USA.
Independent Consultant, Philadelphia, PA, USA.
Neuropsychopharmacology. 2024 Jan;49(1):3-9. doi: 10.1038/s41386-023-01690-5. Epub 2023 Aug 15.
In contrast to most fields of medicine, progress to discover and develop new and improved psychiatric drugs has been slow and disappointing. The vast majority of currently prescribed drugs to treat schizophrenia, mood and anxiety disorders are arguably no more effective than the first generation of psychiatric drugs introduced well over 50 years ago. With only a few exceptions current psychiatric drugs work via the same fundamental mechanisms of action as first-generation agents. Here we describe the reasons for this slow progress and outline a number of areas of research that involve a greater reliance on experimental therapeutics utilizing recent advances in neuroscience to better understand disease biology. We exemplify the potential impact of these areas of research focus with several recent examples of novel agents that have emerged and which support our optimism that newer, more effective and better tolerated agents, are on the horizon. Together with existing drugs these newer agents and novel mechanisms could offer markedly improved functional outcomes for the millions of people still disabled by psychiatric disorders.
与大多数医学领域相比,发现和开发新型和改良精神药物的进展一直缓慢且令人失望。目前用于治疗精神分裂症、情绪和焦虑障碍的绝大多数药物,其疗效可能并不比 50 多年前推出的第一代精神药物更好。除了极少数例外,目前的精神药物的作用机制与第一代药物基本相同。在这里,我们描述了导致这种缓慢进展的原因,并概述了一些研究领域,这些领域需要更多地依赖于利用神经科学最新进展的实验治疗方法,以更好地了解疾病生物学。我们用最近出现的一些新型药物的例子来说明这些研究重点领域的潜力,这些药物支持我们的乐观态度,即更新型、更有效和更耐受的药物即将出现。这些新型药物和新机制与现有的药物一起,可以为数以百万计仍受精神疾病困扰的人提供明显改善的功能结果。