Antidepressants: will new mechanisms of action improve poor outcomes?

摘要

Depressive illnesses cause enormous economic burden and disability (Sobocki et al, 2006). Since the serendipitous discovery of the first antidepressants in the 1950s (Bloch et al, 1954) various antidepressants and psychotherapies are recommended in treatment guidelines (McAllister-Williams, 2006). The advent of the selective serotonin-reuptake inhibitors (SSRI) with improved tolerability and safety (Vaswani et al, 2003) has contributed to a 253% rise in antidepressant prescription over the last decade (Moncrieff and Kirsch, 2005). Despite this, there are serious shortcomings in outcomes for patients (Corcoran and McAllister-Williams, 2007). In particular: 1. A significant proportion of depressed patients do not respond to available treatment strategies