Depression and PTSD Reviewed

The March/April 2018 issue of NeuroPerspective has been released, featuring in-depth reviews of Depression and PTSD.

Depression represents a patient population whose treatment falls far short of the bucolic illustrations suggested by DTC advertising for the current crop of pharmacotherapies. The majority of patients do not find adequate relief from their first trial, and 25% do not find sufficient benefit from any of the antidepressants they try. Aversive side effects, including weight gain and sexual dysfunction, form a significant barrier to utilization, and the long delay to relief is counter-therapeutic. New drugs seem to offer the prospect of near-immediate depression relief, led by the much-publicized impact of IV ketamine. Prominent RAAD programs come from JNJ (whose Phase III results have been delayed without explanation); Allergan; the surprising SAGE Therapeutics program; and potentially, Perception NeuroScience, to name but four. Suicide risk represents a growing societal problem, as is Treatment-Resistant Depression, where nothing seems to work. SAGE has made significant progress with Post-Partum Depression, with Marinus Pharmaceuticals hoping to follow suit. Other antidepressant programs reviewed include those from Alkermes, Blackthorn Therapeutics, NeuralStem, Navitor.

PTSD (Post-Traumatic Stress Disorder) has risen in profile as a result of both natural (tsunamis, firestorms) and human-made (combat, mass shootings) disasters, and the more pervasive but lower profile scourge of sexual/physical/emotional abuse of both children and adults. The pharma industry has generally taken a passive approach to PTSD, leaving the funding of research to the DoD and VA in the US, but small companies are beginning to explore this undertreated and very large-scale domain: Aptinyx, Azevan, Marinus, Rodin, SpringWorks, Tonix Pharma. Interventions can be focused upon attenuating the limbic  system hyperactivation of PTSD and/or accentuating the cognitive rewriting of traumatic memory.

The March/April issue also discusses Pfizer’s CNS retreat; Axovant’s failure; the ‘revision’ of FDA guidelines for Alzheimer’s; and the several high-quality, pioneering partnerships signed in recent months: Takeda with both Denali and Wave Life Sciences, AbbVie with Voyager Therapeutics.