What can triumphs and tribulations from drug research in Alzheimer's disease tell us about the development of psychotropic drugs in general?

Abstract

Drug development for psychiatric disorders has almost ground to a halt. Some newer drugs are better tolerated or safer than older ones, but none is more effective. Years of failure in preventing or delaying the onset of illness, ameliorating symptoms, lowering suicide rates, or improving quality of life has put the commercial investments that had previously funded drug development at risk. To promote the development of psychiatric drugs with greater efficacy, we need to improve the way we bring potentially beneficial drugs to market. We need to acknowledge, as has been done in other specialties, that people differ in their response to drugs. Psychiatric drug research needs to be grounded in a better understanding of molecular brain mechanisms, neural circuits, and their relations to clinical disease. With this understanding, drugs need to be more precisely directed at specific brain targets. In psychiatric drug development, government, industry, regulatory bodies, and academia should realign to ensure medical science is used in the best interests of patients.

Figure 1

Current psychiatric drug development appears to be ‘stuck in a rut’ with ‘me too’ drugs – leading to a famine of new innovative agents reaching patients.

Figure 2

A new model separates academia and industry to function as two independent but collaborative sectors to control conflicts of interest. Governmental funding agencies create an environment that bridges these resources