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Cited by 132Treatment of Major DepressionSchizophrenia research and treatmentHistorical Psychiatry and Medical Practices

Learning from the past and looking to the future: emerging perspectives for improving the treatment of psychiatric disorders

Millan, Mark J., Goodwin, Guy M., Meyer-Lindenberg, Andreas, Ove Ögren, Sven·2015·European Neuropsychopharmacology
DOI 10.1016/j.euroneuro.2015.01.016
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Abstract

Modern neuropsychopharmacology commenced in the 1950s with the serendipitous discovery of first-generation antipsychotics and antidepressants which were therapeutically effective yet had marked adverse effects. Today, a broader palette of safer and better-tolerated agents is available for helping people that suffer from schizophrenia, depression and other psychiatric disorders, while complementary approaches like psychotherapy also have important roles to play in their treatment, both alone and in association with medication. Nonetheless, despite considerable efforts, current management is still only partially effective, and highly-prevalent psychiatric disorders of the brain continue to represent a huge personal and socio-economic burden. The lack of success in discovering more effective pharmacotherapy has contributed, together with many other factors, to a relative disengagement by pharmaceutical firms from neuropsychiatry. Nonetheless, interest remains high, and partnerships are proliferating with academic centres which are increasingly integrating drug discovery and translational research into their traditional activities. This is, then, a time of transition and an opportune moment to thoroughly survey the field. Accordingly, the present paper, first, chronicles the discovery and development of psychotropic agents, focusing in particular on their mechanisms of action and therapeutic utility, and how problems faced were eventually overcome. Second, it discusses the lessons learned from past successes and failures, and how they are being applied to promote future progress. Third, it comprehensively surveys emerging strategies that are (1), improving our understanding of the diagnosis and classification of psychiatric disorders; (2), deepening knowledge of their underlying risk factors and pathophysiological substrates; (3), refining cellular and animal models for discovery and validation of novel therapeutic agents; (4), improving the design and outcome of clinical trials; (5), moving towards reliable biomarkers of patient subpopulations and medication efficacy and (6), promoting collaborative approaches to innovation by uniting key partners from the regulators, industry and academia to patients. Notwithstanding the challenges ahead, the many changes and ideas articulated herein provide new hope and something of a framework for progress towards the improved prevention and relief of psychiatric and other CNS disorders, an urgent mission for our Century.

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Crossref · 10.1016/j.euroneuro.2015.01.016

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685 of 685 references verified0 citation errors · 0 not checkable

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  • Today's psychiatric pharmaceuticals almost all target signaling by monoamine neuromodulators dopamine, serotonin, noradrenaline and/or histamine and their selective GPCR receptors.

    “Today’s psychiatric pharmaceuticals almost all target signaling by the monoamine neuromodulators dopamine, serotonin, noradrenaline and/or histamine and their selective GPCR receptors (Data-Franco et al., 2017; Hamon and Blier, 2013; Millan et al., 2015; Urs et al., 2014).”

    From Single-cell transcriptomic evidence for dense intracortical neuropeptide networks (2019) · cites this paper as Millan et al., 2015

  • The expectation that highly selective agents acting on specific molecular targets would yield better and safer psychiatric drugs has not been realised.

    “the expectation that highly selective agents acting on specific molecular targets would yield better and safer psychiatric drugs has not been realised (Griebel & Holmes, 2013;Millan, Goodwin, Meyer-Lindenberg, & Ove Ogren, 2015).”

    From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as Millan, Goodwin, Meyer-Lindenberg, & Ove Ogren, 2015

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Authors
Millan, M. J., Goodwin, G. M., Meyer-Lindenberg, A., & Ove Ögren, S.
Affiliations
  • Servier (France) (FR)
  • Warneford Hospital (GB)
ORCID
Venue
European Neuropsychopharmacology
Publisher
Elsevier BV
Published
2015-05
Volume
25
Issue
5
Pages
599-656
ISSN
0924-977X (ISSN-L)
DOI
10.1016/j.euroneuro.2015.01.016
OpenAlex
W2166279367
Semantic Scholar
fcbde5665a6187ecde3bf30530ee2f19baab7906
Cited by
132
References
691
Citations by year
2026: 8 · 2025: 7 · 2024: 2 · 2023: 10 · 2022: 14 · 2021: 6 · 2020: 13 · 2019: 14 · 2018: 19 · 2017: 16 · 2016: 17 · 2015: 6
FWCI
2.43
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • European Neuropsychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute for Health and Care Research (NF-SI-0513-10010)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
Keywords
neuropsychopharmacology, antipsychotic drugs, antidepressants, schizophrenia, depression, mental illness, mechanism of action, risk factors, pathophysiology, animal models, cell model, clinical trial design, biomarkers, translational research, university-industry collaboration, drug development
MeSH terms
Animals, Mental Disorders, Humans, Psychopharmacology, Psychotropic Drugs, History, 20th Century

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