新抗抑郁药物的发现是否有意外收获?使用操作标准的历史分析。

IF 1.3 Q3 PSYCHIATRY
Alpha psychiatry Pub Date : 2025-04-28 eCollection Date: 2025-04-01 DOI:10.31083/AP40037
Francisco López-Muñoz, Pilar D'Ocón, Alejandro Romero, Domenico De Berardis, Cecilio Álamo
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引用次数: 0

摘要

目的:考虑到它们的重要性,作为世界范围内处方最多的治疗药物之一,我们分析了意外发现在发现新的抗抑郁药中的作用,范围从选择性血清素再摄取抑制剂到更多的当代发展。方法:我们对新抗抑郁药的发现进行了历史分析,采用了我们小组制定的意外发现的操作标准,并参考了有关其发展的原始文章(最初的药理和临床信息)。结果:选择性5 -羟色胺再摄取抑制剂(氟西汀、氟伏沙明、西酞普兰、帕罗西汀、舍曲林和艾司西酞普兰)、选择性多巴胺和去甲肾上腺素再摄取抑制剂(安非他酮)、去甲肾上腺素和5 -羟色胺再摄取抑制剂(文拉法辛、米那西普兰、度洛西汀和地文拉法辛)、选择性去甲肾上腺素再摄取抑制剂(瑞波西汀)、去甲肾上腺素能和特定5 -羟色胺能抗抑郁药(米氮平)、褪黑激素激动剂(阿戈美拉汀)、血清素调节剂和刺激剂(沃替西汀、维拉唑酮、天奈汀)对应于IV型。莫氯贝胺是一种可逆的单胺氧化酶抑制剂,符合II型模式,对于II型模式,最初的偶然发现(即,在研究单胺氧化酶(MAO)的抗高脂血症特性时偶然发现的抑制作用)导致随后的非偶然发现(临床抗抑郁疗效)。氯胺酮是一种谷氨酸能调节剂,符合III型模式,其特点是非偶然的起源(最初发展为麻醉剂),导致偶然的观察(发现非法使用个体的抗抑郁功效)。结论:除莫氯贝胺(II型)和氯胺酮(III型)外,大多数新型抗抑郁药遵循IV型模式,其特点是理性和有针对性的设计过程,偶然性不起作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Did Serendipity Contribute to the Discovery of New Antidepressant Drugs? Historical Analysis Using Operational Criteria.

Objective: Given their great importance, as one of the most prescribed types of therapeutic drugs worldwide, we have analyzed the role of serendipity in the discovery of new antidepressants, ranging from selective serotonin reuptake inhibitors to more contemporary developments.

Methods: We carried out a historical analysis of the discovery of new antidepressants, resorting to the original articles published on their development (initial pharmacological and clinical information) and applied an operational criterion of serendipity developed by our group.

Results: Selective serotonin reuptake inhibitors (fluoxetine, fluvoxamine, citalopram, paroxetine, sertraline, and escitalopram), selective dopamine and noradrenaline reuptake inhibitors (bupropion), noradrenaline and serotonin reuptake inhibitors (venlafaxine, milnacipram, duloxetine, and desvenlafaxine), selective noradrenaline reuptake inhibitors (reboxetine), noradrenergic and specific serotonergic antidepressants (mirtazapine), melatonergic agonists (agomelatine), and serotonin modulators and stimulators (vortioxetine, vilazodone, tianeptine) correspond to the type IV pattern. Moclobemide, a reversible monoamine oxidase inhibitor, corresponds to the type II pattern, for which the initial serendipitous findings (i.e., the chance discovery of the inhibitory effects of monoamine oxidase (MAO) whilst being studied for their antihyperlipidemic properties) led to subsequent non-serendipitous discoveries (clinical antidepressant efficacy). Ketamine, a glutamatergic modulator, corresponds to the type III pattern, characterized by a non-serendipitous origin (initial development as an anesthetic agent) leading to a serendipitous observation (the discovery of antidepressant efficacy in individuals illicitly using).

Conclusion: The majority of new antidepressants adhere to a type IV pattern, characterized by a rational and targeted design process where serendipity played no part, except moclobemide (type II pattern) and ketamine (type III pattern).

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