The brain is by far our most complex organ, and although extremely common and more draining to society than any other afflictions, mental illnesses remain little understood. We now realize that no single gene is to blame. Nor any single environmental insult. Therefore, progress to develop new treatments will remain challenging.
We must realize that our current arsenal of drugs to treat mental illnesses, however imperfect, has transformed many aspects of our society over the past half century. But these existing drugs can at best treat symptoms and will not significantly impact the underlying disease. Nonetheless, when used properly, current medications can help ease human suffering among the mentally ill, ideally when used in combination with other therapeutic interventions.
Looking back, the purely unexpected discovery of lithium, chlorpromazine (the first antipsychotic drug) and several antidepressants around the 1950s promised rapid therapeutic progress. However, the picture today is painfully different. Progress has been limited largely to reducing side effects or making dosing easier for patients. Strikingly, we still do not know how psychotherapeutics exert their desired effects.
In recent years, very few new drugs have been introduced in psychiatry. In fact, in 2016 there was just one new drug approved by the FDA. That drug, Nuplacid, can be used for the treatment of hallucinations and delusions sometimes seen in people with Parkinson’s disease. Another new drug, Vraylar, approved in 2015, can be used in schizophrenia and may affect some symptoms that are not well treated with older drugs.
Today there is reason for cautious optimism because basic research is progressing at a much faster pace than ever before. We know much more about the brain and how it is formed. Progress has been fueled by multiple new technologies. Many researchers feel that with cutting-edge science and strategies will come a new wave of therapeutic discovery benefiting the mentally ill.
The need for progress in behavioral health is arguably greater than in any other area of medicine. The brain is sometimes viewed as the final frontier in human biology and medicine. We know that drugs can improve mental disorders and save lives. The hunt for fundamentally new ones cannot stop as we inch closer to finding better treatments for the millions affected by a behavioral health illness.
Dr. Claes Wahlestedt is a psychiatrist with the University of Miami Health System. To learn more about UHealth’s clinical services, visit umiamihospital.com/specialties/psychiatry.