13 Psychiatric Drugs With Novel Mechanisms: A Timeline

August 10, 2020

Some speculate the pharmaceutical industry has virtually abandoned new drug development in neuroscience with a few exceptions. However, it should be noted that progress has been made.

Some speculate the pharmaceutical industry has virtually abandoned new drug development in neuroscience with a few exceptions. However, it should be noted that progress has been made.

1987 FDA approval of our first selective serotonin reuptake inhibitor: fluoxetine.

1989: FDA approval of our first and paradigm changing atypical antipsychotic for refractory schizophrenia. Clozapine.

1989 FDA approval of our first drug to treat obsessive-compulsive disorder, which was synthesized by chlorinating imipramine and resulting in a higher potency of elevating brain serotonin: clomipramine.

1994 FDA approval of our first alpha-2-delta subunit antagonist of the neuronal voltage-gated calcium channel: gabapentin (followed by its sibling pregabalin).

1998: FDA approval of our first phosphodiesterase type 5 inhibitor for the treatment of erectile dysfunction.

2002 FDA approval of our first dopamine-2 receptor antagonist/partial agonist: aripiprazole.

2006 FDA approval of our first cholinergic nicotinic subreceptor specific drug for the treatment of cigarette smoke cessation, which has high-affinity partial agonism for the α4β2 nicotinic acetylcholine receptor subtype: varenicline.

2014 FDA approval of our very first selective, dual orexin receptor antagonist (DORA) for the treatment of insomnia: suvorexant.

2015 FDA approval of our very first dopamine-3 selective/dopamine-2 antagonist partial agonist: cariprazine.

2016 FDA approval of our first serotonin 5HT-2A inverse agonist/antagonist for the treatment of hallucinations and delusions associated with Parkinson disease: pimavanserin.

2017 FDA approval of our very first drugs for the treatment of tardive dyskinesia by the novel mechanism of inhibiting the vesicular monoamine transporter, type 2 (VMAT-2): deutetrabenazine and valbenazine.

2019 FDA approval of our very first glutamate specific drug for treatment-resistant depression: esketamine.

For more on this topic, see My Wow and Awesome Responses While Reading the Psychiatric Literature, on which this slideshow is based.

13 Psychiatric Drugs With Novel Mechanisms: A Timeline

John J. Miller, MD

Some speculate the pharmaceutical industry has virtually abandoned new drug development in neuroscience with a few exceptions. However, it should be noted that progress has been made.