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 The depression drug pipeline has run dry partly due to a "failure of
science" they said, but also due to big pharma pulling investment
out of research and development (R&D) in the neuroscience field
because the profit potential is uncertain.
"I'd be very surprised if we were to see any new drugs for
depression in the next decade. The pharmaceutical industry is simply
not investing in the research because it can't make money from these
drugs," Guy Goodwin, a professor of psychiatry at the University of
Oxford, told reporters at a London briefing.
Andrea Cipriani, a consultant psychiatrist at Oxford, said such risk
aversion was understandable given uncertain returns and the
approximately billion dollar cost of developing and bringing a new
drug to market.
"It's a lot of money to spend, and there's a high rate of failure,"
Cipriani said.
Treatment for depression usually involves either medication, some
form of psychotherapy, or a combination of both. But up to half of
all people treated fail to get better with first-line
antidepressants, and around a third of patients are resistant to
relevant medications.
DEPRESSION RATES RISING
The experts said that since the current generation of SSRI
(selective serotonin reuptake inhibitors) antidepressants -
including Pfizer's blockbuster Prozac - are widely available as
cheap generics, there is reluctance among health services to fund
expensive new drugs that may not be much better.
That is partly because existing medications, whilst by no means
perfect, are quite effective in more than half of patients, the
specialists said, and partly because in this condition in
particular, placebo can have a massive impact.
That makes it difficult, they explained, to show that a new drug is
working above and beyond a positive placebo response and an already
effective generation of available drugs.
Depression is already one of the most common forms of mental
illness, affecting more than 350 million people worldwide and
ranking as the leading cause of disability globally, according to
the World Health Organization.
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And rates are rising. Glyn Lewis, a professor of psychiatric
epidemiology at University College London, cited data for England
showing a doubling in prescriptions for antidepressants in a decade,
to 61 million in 2015 from 31 million in 2005.
In the United States too, more people than ever are taking
antidepressants. A study in the Journal of the American Medical
Association (JAMA) in 2015 found that prevalence almost doubled from
1999 to 2012, rising to 13 from 6.9 percent.
Yet several major drug companies including GlaxoSmithKline and
AstraZeneca have scaled right back on neuroscience R&D in recent
years, citing unfavorable risk-reward prospects.
Goodwin said the absence of a drug development pipeline was also due
to lagging scientific research into what is really happening in the
brains of those who do and do not respond to current
antidepressants.
"It's partly a failure of science, to be frank," said Goodwin.
"Scientists have to ... get more of an understanding about how these
things actually work before we can then propose ways to improve
them."
(Reporting by Kate Kelland, editing by Richard Lough)
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