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Novel Molecular Targets for Mood Disorders and Psychosis: Proceedings of a Workshop [Pehme köide]

  • Formaat: Paperback / softback, 88 pages, kõrgus x laius: 229x152 mm
  • Ilmumisaeg: 02-Dec-2021
  • Kirjastus: National Academies Press
  • ISBN-10: 0309685907
  • ISBN-13: 9780309685900
Teised raamatud teemal:
  • Formaat: Paperback / softback, 88 pages, kõrgus x laius: 229x152 mm
  • Ilmumisaeg: 02-Dec-2021
  • Kirjastus: National Academies Press
  • ISBN-10: 0309685907
  • ISBN-13: 9780309685900
Teised raamatud teemal:
Mood disorders - including depression and bipolar disorder - are common, disabling, and potentially lethal disorders, characterized by a shortened lifespan from comorbid medical illness and rising suicide rates. Medications for these conditions have been shown to be insufficiently effective in the majority of people who take them, and there remains a tremendous unmet medical need. Recent advances towards understanding the mechanisms of action for psychiatric medicines have led to the identification of potential novel molecular targets and agents for treating mood disorders. While these promising avenues for further investigation have re-energized scientific research in this area, many open questions remain. In response to this interest, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders convened a workshop in March 2021, Novel Molecular Targets for Mood Disorders and Psychosis.



The goal of this workshop was to explore the landscape of novel pharmacologic treatments for psychiatric disorders, review the challenges and opportunities that have been highlighted by the development of recently approved drugs, and reflect on how to apply those lessons learned towards current and future efforts to identify and validate additional novel molecular targets. With a grounding in the personal experiences of patients living with depression and schizophrenia, workshop participants discussed the scientific, clinical, technological, regulatory, and ethical considerations of this topic. Examples of drug classes discussed in the workshop include antagonists for NMDA (N-methyl-D-aspartate) receptors and GABA (gamma-aminobutyric acid) receptors, as well as modulators for muscarinic and serotonergic receptors. This publication summarizes the presentations and discussions from the workshop.

Table of Contents



Front Matter 1 Introduction and Background 2 Current Drug Development Landscape and Limitations of Molecular Targets for Mood Disorders and Psychosis 3 Targeting Glutamate Receptors for Treatment-Resistant Depression 4 Targeting GABA Receptors to Treat Postpartum Depression 5 Emerging Drug Targets 6 Regulatory Considerations for the Next Generation of Psychiatric Drugs 7 Ethical and Legal Principles Related to the Clinical Use of Psychoactive Drugs 8 Potential Next Steps and Future Opportunities Appendix A: References Appendix B: Workshop Agenda
Acronyms and Abbreviations xiii
1 Introduction and Background
1(4)
Workshop Objectives
2(1)
Organization of the Proceedings
2(3)
2 Current Drug Development Landscape And Limitations Of Molecular Targets For Mood Disorders And Psychosis
5(8)
The Lived Experience of Schizophrenia
6(1)
Living with Depression
7(3)
Serendipity in Psychiatric Drug Discovery
10(2)
Unmet Needs in Treating Psychiatric Disorders
12(1)
3 Targeting Glutamate Receptors For Treatment-Resistant Depression
13(12)
A Brief History of Ketamine and Esketamine
14(1)
Clinical and Patient Experiences with Intranasal Esketamine
15(2)
Ketamine's Mechanism of Action on Synapses, Circuits, and Systems
17(3)
Strategies to Improve the Antidepressant Effects of Ketamine
20(3)
Identifying a Biomarker to Help Predict Responses to Ketamine
23(2)
4 Targeting Gaba Receptors To Treat Postpartum Depression
25(6)
Clinical and Patient Experiences with Brexanolone
26(2)
Brexanolone's Mechanism of Action
28(1)
Convergence of Mechanisms: Ketamine and Brexanolone
29(2)
5 Emerging Drug Targets
31(10)
mTOR Signaling---A Target for Depression and Psychosis
32(1)
Serotonin 5-HT2 Receptor Agonists for Mental Disorders
33(2)
TAAR1/5-HT1AR Agonists in Schizophrenia Treatment
35(2)
M1/M4 Acetylcholine Muscarinic Receptor Targeting for Psychosis
37(1)
NMDA Modulation to Improve Negative and Cognitive Symptoms in Schizophrenia
38(1)
The Added Complexity of Polypharmacy
38(3)
6 Regulatory Considerations For The Next Generation Of Psychiatric Drugs
41(6)
The Approval of Esketamine
43(1)
The Approval of Brexanolone
44(3)
7 Ethical And Legal Principles Related To The Clinical Use Of Psychoactive Drugs
47(8)
Translating Ethical Principles to the Clinical Use of Psychoactive Drugs
48(6)
Psilocybin Therapy: Clinical Use and Legal Challenges
54(1)
8 Potential Next Steps And Future Opportunities
55(6)
Novel Approaches Needed to Address Unanswered Questions
57(2)
Final Thoughts on the Future of Therapy for Psychiatric Disorders
59(2)
APPENDIXES
A References
61(6)
B Workshop Agenda
67