Psychiatric drug development: Are we in a rut?

Obsessive Compulsive Disorder (OCD)

What are obsessions? What are compulsions? How common is OCD? What are the treatment options for the patient with OCD?

Depression and osteoporosis

Osteoporosis occurs when bones become brittle and are at risk of breaking.  Hip fractures are a common occurrence in severe osteoporosis. All races are at risk of osteoporosis, and post-menopausal women are at particular risk. Clinical depression is a risk factor for osteoporosis.  High levels of cortisol, which occur in depression, weaken bones.  Osteocalcin, necessary for new bone formation, is reduced in depression.   The biology of depression increases the risk of osteoporosis.  Countering these effects with increased intake of vitamin D and calcium, along with weight-bearing exercise, is necessary for preventing osteoporosis.

Depression and heart disease

Depression significantly increases the risk of heart disease. How? Probably by increasing inflammatory molecules in the bloodstream, increasing cortisol and making platelets more adhesive. It is imperative that we treat depression effectively, either by physical means, psychological means or a combination.    Untreated depression has major physical implications.

Psychiatric drug development: Are we in a rut?

The 1950s were the golden age of psychiatric drug development.  Along came antipsychotics and antidepressants. Are the newer drugs better than the older drugs in terms of efficacy?  The answer unquestionably is no.   They are no more effective but have different side effects. Is there still a role for old drugs?  Yes, there is. Should benzodiazepines be used to treat anxiety or sleep disturbance?  Not always, but for many people, yes.

Psychedelics

What are psychedelics? In what areas of psychiatry are psychedelics being developed? Why do conventional journals publish studies with low numbers of patients? Will psychedelics ever reach the market?