On 18A/C, there have been a number of very expensive trials for new antidepressant agents, including for TRD . . . and they have generally underperformed in Stage III trials. There is a huge financial incentive for a successful product in this area in the high-income markets. So not particularly neglected, and I’m not sold on tractability either. For example, I don’t think the current armamentum of antidepressants as monotherapy is more effective than the old school MAOIs and TCAs from decades ago (although the drug interactions, cheese-eating risk, and overdose risk SSRIs are much improved with SSRIs etc.).
I think promoting access to mental-health care in low-income countries is an easier argument to make than throwing billions more into trying to find a better treatment for TRD.
On 18A/C, there have been a number of very expensive trials for new antidepressant agents, including for TRD . . . and they have generally underperformed in Stage III trials. There is a huge financial incentive for a successful product in this area in the high-income markets. So not particularly neglected, and I’m not sold on tractability either. For example, I don’t think the current armamentum of antidepressants as monotherapy is more effective than the old school MAOIs and TCAs from decades ago (although the drug interactions, cheese-eating risk, and overdose risk SSRIs are much improved with SSRIs etc.).
I think promoting access to mental-health care in low-income countries is an easier argument to make than throwing billions more into trying to find a better treatment for TRD.
Good point, this makes sense.