Commentary on the limitation of antidepressants in current use

Abstract

Antidepressants in current use are generally classified by their immediate pharmacological actions [1, 2]. Thus, there are two classical pharmacological classes that include over a dozen individual drugs and the six newer pharmacological classes that include at least 10 specific agents (Tab. 1) [1, 2]. As a group, these antidepressants are important therapeutic agents with many favorable characteristics. The newer antidepressants have a better safety profile than the classical antidepressants. All antidepressants, however, are generally recognized as effective for the majority of patients with major depressive disorder, and also have an ever expanding portfolio of therapeutic actions in other disorders, such as panic disorder, obsessive compulsive disorder, generalized anxiety disorder, social phobia, post-traumatic stress disorder, and many others. Over half of patients with depression treated with any of the currently available antidepressants will respond to treatment, and over 90% will respond if several antidepressants are tried in sequence, or combinations of antidepressants and other drugs are administered [3-5]. Antidepressants also reduce relapse rates for the first 6 to 12 months after improving from an episode of major depressive disorder [6]. So what could possibly be the limitations of drugs with so many positive features?