SSRIs were a 'wonder drug'—then the research stopped. Here's why
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"Aside from ketamine, most recently, and drugs like Auvelity, we have not really seen any major breakthroughs since SSRIs." — Alex Dimitriu, MD, double board-certified psychiatrist and sleep medicine physician
Seeing how popular antidepressant medications are, such as selective serotonin reuptake inhibitors (SSRIs), it’s a wonder that pharmaceutical companies have cut back on researching and developing them.
A recent report called the development of psychiatric drugs “slow and disappointing.” [] But research also shows there’s an urgent need for new medications for psychiatric disorders. []
Why? Because mental illness is expected to become the leading cause of disability by 2030.
Related: Experts push back as RFK Jr. compares SSRIs to heroinSo, what exactly is going on?
According to Alex Dimitriu, MD, a double board-certified psychiatrist and sleep medicine physician and founder of Menlo Park Psychiatry & Sleep Medicine, the mental health space has been stuck for a while.
“Aside from ketamine, most recently, and drugs like Auvelity, we have not really seen any major breakthroughs since SSRIs,” Dr. Dimitriu tells MDLinx.
According to Ozan Toy, MD, MPH, chief medical officer at Telapsychiatry in New Jersey, developing psychiatric drugs can be a difficult task for scientists because there's so much we don’t yet understand about the brain.
“Our understanding of its function is more limited than other organ systems,” Dr. Toy tells MDLinx.
The future of psychotropic drug development
Nevertheless, Dr. Dimitriu remains optimistic for psychotropic drug development. Mental health disorders impact so many people, especially in the United States, making for a huge market, he says.
There’s a lot to be discovered, and future research will likely open up new pathways for drug development.
“Enhancing neuroplasticity, reducing brain inflammation or glycemic control, and modifying sleep architecture and slow-wave sleep are all very promising avenues, which will be a jackpot for whichever company is first to strike gold,” says Dr. Dimitriu.
Dr. Dimitriu compares the mental health drug pipeline to the weight loss industry. Weight loss drugs stalled out for years—and were in a similar doldrum. “Then we saw the Ozempic explosion,” he says.
Might the same happen with psychiatric drugs? It’s on the horizon, research suggests. [] That's because there’s finally renewed interest and excitement around investing in the finances, research, and resources needed to create novel drugs for increasingly common psychiatric illnesses.
Related: Why patients may be panic-stocking SSRIs—and what you should tell them