Pharmacologic characteristics of ideal antidepressants in the 21st century

The availability of drugs for use as antidepressants has expanded greatly in the past 2 decades. Not only has the number of drugs increased but so has the diversity in associated pharmacologic effects. Drug development for central nervous system agents is proceeding at an accelerated pace. The coming decades hold the promise for the introduction of newer antidepressants that have novel mechanisms of action, improved adverse event profiles, and expanded indications. Unfortunately, the ideal antidepressant is yet to be formulated. Pharmacologic characteristics for desirable improvements are discussed relative to the currently available drugs.