Nutt David J
Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.
Lancet Psychiatry. 2025 Mar;12(3):228-238. doi: 10.1016/S2215-0366(24)00370-5. Epub 2025 Feb 11.
The past 50 years have seen remarkable advances in the science of medicine. The pharmacological treatments of disorders such as hypertension, immune disorders, and cancer are fundamentally different from those used in the 1970s, and are now more often based on disorder-specific pathologies. The same cannot be said for psychiatric medicines: despite remarkable advances in neuroscience, very few innovative treatments have been developed in this field since the 1970s. For depression, schizophrenia, anxiety disorders, and ADHD, pharmacological classes of medicines discovered through serendipity in the 1950s are still used despite hundreds of billions of US dollars being spent on drug discovery attempts based on new neuroscience targets. This Personal View presents my opinion on the reasons innovation in psychiatric treatment has not progressed as well as in other disorders. As a researcher in the field, I offer suggestions as to how this situation must be rectified soon, as by most analyses mental illness is becoming a major health burden globally. Most of my evidence is referenced, but where I have unpublished knowledge gained from consulting with pharmaceutical companies, it is presented as an opinion.
在过去的50年里，医学科学取得了显著进展。高血压、免疫紊乱和癌症等疾病的药物治疗与20世纪70年代所使用的治疗方法有着根本的不同，现在更多地基于特定疾病的病理情况。精神科药物则不然：尽管神经科学取得了显著进展，但自20世纪70年代以来，该领域几乎没有开发出创新性的治疗方法。对于抑郁症、精神分裂症、焦虑症和注意力缺陷多动障碍，尽管基于新的神经科学靶点进行药物研发投入了数千亿美元，但20世纪50年代偶然发现的几类精神科药物仍在使用。这篇个人观点文章阐述了我对精神科治疗创新未能像其他疾病那样取得进展的原因的看法。作为该领域的一名研究人员，鉴于多数分析表明精神疾病正成为全球主要的健康负担，我就如何尽快纠正这种情况提出了建议。我的大部分证据都有参考文献，但对于我从与制药公司咨询中获得的未发表的知识，我将其作为一种观点呈现。
