Osaka Hitoshi, Kanazawa Tetsufumi
Department of Neuropsychiatry Osaka Medical and Pharmaceutical University Takatsuki-city Osaka Japan.
PCN Rep. 2023 Nov 20;2(4):e157. doi: 10.1002/pcn5.157. eCollection 2023 Dec.
The domain of psychiatric drug development is currently witnessing a notable transformation, with a paramount emphasis on targeting nonmonoamine receptors and exploring inventive mechanisms of action. This paper presents an overview of the ongoing advancements in antipsychotic and antidepressant drug development. Historically, antipsychotics predominantly targeted dopamine receptors, but there is now an escalating interest in drugs that act on alternative receptors, exemplified by the TAAR1 receptor. One noteworthy candidate is Ulotaront (SEP-363856), an agent acting as a TAAR1 agonist with 5-HT1A agonist activity, demonstrating promising outcomes in the treatment of schizophrenia, devoid of extrapyramidal symptoms or metabolic side-effects. Similarly, MIN-101 (Roluperidone) and KarXT are currently in development, with its focus on addressing the symptoms in schizophrenia. In the domain of antidepressants, novel therapeutic approaches have surfaced, such as Auvelity, a Food and Drug Administration (FDA)-approved NMDA receptor antagonist synergistically combined with Bupropion to enhance its effects. Another notable candidate is Zuranolone, operating as a GABA A receptor-positive allosteric modulator, showcasing efficacy in treating major depressive disorder (MDD) and postpartum depression. Additionally, TAK-653 (NBI-1065845) and MJI821 (Onfasprodil) have emerged as potential antidepressants targeting AMPA receptors and NMDA receptor 2B (NR2B) negative allosteric modulation, respectively. This paper underscores the transformative potential of these novel drug candidates in psychiatric treatment and their ability to address cases that were previously treatment-resistant. By focusing on nonmonoamine receptors and introducing innovative mechanisms, these drugs offer a promising prospect of improved outcomes for individuals suffering from schizophrenia and MDD. Thus, sustained attention and dedication to the development of such drugs are essential to augmenting the therapeutic options available for psychiatric patients.
精神科药物研发领域目前正经历显著变革,重中之重是针对非单胺受体并探索创新作用机制。本文概述了抗精神病药物和抗抑郁药物研发的当前进展。从历史上看,抗精神病药物主要作用于多巴胺受体,但如今人们对作用于其他受体的药物兴趣与日俱增,以TAAR1受体为例。一个值得关注的候选药物是乌洛托隆(SEP - 363856),它是一种兼具5 - HT1A激动剂活性的TAAR1激动剂,在治疗精神分裂症方面显示出有前景的疗效,且无锥体外系症状或代谢副作用。同样,MIN - 101(罗芦必利酮)和KarXT目前也在研发中,重点在于解决精神分裂症的症状。在抗抑郁药领域,出现了新的治疗方法,如经美国食品药品监督管理局(FDA)批准的奥维力特,它是一种NMDA受体拮抗剂,与安非他酮协同组合以增强疗效。另一个值得注意的候选药物是 zuranolone,它作为GABA A受体正向变构调节剂,在治疗重度抑郁症(MDD)和产后抑郁症方面显示出疗效。此外,TAK - 653(NBI - 1065845)和MJI821(昂法司地尔)分别作为靶向AMPA受体和NMDA受体2B(NR2B)负向变构调节的潜在抗抑郁药崭露头角。本文强调了这些新型候选药物在精神科治疗中的变革潜力以及它们解决既往难治病例的能力。通过关注非单胺受体并引入创新机制,这些药物为精神分裂症和MDD患者带来了改善预后的希望前景。因此,持续关注并致力于此类药物的研发对于增加精神科患者可用的治疗选择至关重要。