The enantiomer debate: current status and future directions

Psychopharmacology, and the treatment of depression in particular, is one area where there is currently an increasing awareness of chiral drug phenomena. It is now generally agreed that the pharmacological and pharmacokinetic properties of chiral drugs and their enantiomers should be assessed early on in the drug development process. However, issues surrounding the potential advantages and disadvantages of enantiomeric drugs, compared with racemates, continue to be debated. This article highlights some of the key issues raised during one such debate, the aim of which was to address the hypothesis that each enantiomeric drug should be considered on its own merit. The idea is considered both in general terms and specifically in the context of clinical psychiatry, with an emphasis on the treatment of depression. An update on recent developments in enantiomeric antidepressant therapy is also provided. Copyright 2001 John Wiley & Sons, Ltd.