A review of new antidepressant drugs

Depression is a relatively common mental illness. If you have depression, you must take medication in time. Through good medication, you can control the disease and relieve the patient's symptoms. With the advancement of medical technology, new antidepressant drugs are gradually being improved. These new drugs have fewer side effects than traditional drugs, which is a good thing for patients with depression.

1. Brintellix

Brintellix, generic name Vortioxetine, is a drug that regulates and promotes serotonin secretion. It is an atypical antidepressant. Its mechanism is not fully understood yet, but it has been found that it also functions as a serotonin reuptake inhibitor, norepinephrine reuptake inhibitor, 5-HT 1A receptor agonist, and 5-HT 1B receptor partial agonist. Takeda Pharmaceuticals (http://www.chemdrug.com/) claims that this drug is the only one that boosts serotonin levels through this combined function, although it is not yet clear how much each function contributes to its antidepressant effect. In addition to improving patients' mood, clinical studies have shown that this drug can also improve cognitive function, which can be regarded as a progressive drug for antidepressants currently on the market. The drug is co-marketed by Takeda and Denmark's Lundbeck (http://www.chemdrug.com/company/), in a deal that sees Takeda pay Lundbeck $40 million upfront and up to $345 million in milestone payments. It was launched in the United States and the European Union in 2013, with sales forecast to reach US$845 million in 2017 and US$1.75 billion in 2021.

2. Pristiq Desvenlafaxine

Pristiq's generic name is Desvenlafaxine, which is a serotonin and norepinephrine reuptake inhibitor (SNRI). The drug is taken once a day and was approved for marketing by the FDA (http://www.chemdrug.com/article/11/) in 2008. Desvenlafaxine is the main active substance of venlafaxine (the active ingredient of another antidepressant drug Effexor) in the body. Studies have shown that in more than 70% of patients, venlafaxine exerts its effect by being metabolized to desvenlafaxine. Sales of this drug have been rising steadily since its launch, with sales forecast to reach $800 million in 2017 and $890 million in 2021.

3. Rexulti

Rexulti, generic name Brexpiprazole, is a new type of antipsychotic drug. It was approved by the FDA on July 13, 2015 for the treatment of schizophrenia and depression. The drug was jointly developed by Japan's Otsuka Pharmaceutical and Denmark's Lundbeck Pharmaceuticals, of which the latter accounts for 50% of sales in Europe and Canada and 45% of sales in the United States. The exact mechanism of action of Rexulti in treating major depression and schizophrenia is still unclear. This drug is structurally similar to Otsuka's best-selling antipsychotic drug Abilify. They both have partial agonist activity at dopamine D2 receptors, but Rexulti's antagonist activity at 5-HT 1A receptors and serotonin 5-HT 2A receptors is stronger, which may explain its antidepressant function. The sales prospects of this drug are optimistic by many research institutions, which predict sales of US$112 million in 2017 and US$1.35 billion in 2021.

4. Cymbalta

Duloxetine, the generic name of Cymbalta, is also a serotonin and norepinephrine reuptake inhibitor. The sales of this drug in 2013 once reached 5.084 billion US dollars, setting a sales record for antidepressants. However, compared with its brilliant sales, its therapeutic effect is not so outstanding. Many studies have shown that compared with other antidepressants, its therapeutic effect is not outstanding, and it is also found that its side effects are relatively large. Its high sales may come from the brand effect and high price. After the patent expired in 2013, sales plummeted from 5 billion US dollars to 1.6 billion US dollars. This figure also reflects that it has no advantages over generic drugs. It is predicted that the sales will be 450 million US dollars in 2017 and 290 million US dollars in 2021.

5. Cipralex Escitalopram

Cipralex's generic name is escitalopram, which belongs to the selective serotonin reuptake inhibitors (SSRIs). Escitalopram is a derivative of R-citalopram, another antidepressant produced by Lundbeck Pharmaceuticals. Escitalopram is a highly selective 5-HT reuptake inhibitor with minimal effect on norepinephrine and dopamine. The effect of escitalopram in inhibiting 5-HT reuptake is 100 times that of R-citalopram. This is also an off-patent drug with forecast sales of $330 million in 2017 and $290 million in 2021.

6. Zoloft

Zoloft, also known as sertraline hydrochloride, is a selective serotonin reuptake inhibitor. In addition to being used to treat depression, it is also used for obsessive-compulsive disorder and post-catastrophic stress disorder. This drug is listed as a first-line drug for the treatment of depression and obsessive-compulsive disorder in many domestic and international treatment guidelines. However, compared with other SSRIs, it has a higher chance of diarrhea as a side effect. Its sales volume reached $3.3 billion at its peak. After the patent expired in 2006, sales volume dropped from $3.252 billion to $531 million. Sales volume will not change much in the next few years. Sales volume is predicted to reach $300 million in 2017 and $220 million in 2021.