Benefits and limitations of major pharmacological treatment for depression

An extensive amount of research in clinical psychiatry, psychopharmacology, and the neurosciences has led to effective pharmacological treatments for affective disorders. These impressive developments have suffered from several limitations. In the case of antidepressant drugs, the delayed onset of antidepressant effect, troublesome side effects, possible lethality after an overdose, and the 20 to 30 percent of depressed patients not responsive to them have made these drugs less than a panacea. In addition to the limitations of the drugs themselves, there is frequently inattention to pharmacotherapeutic principles by clinicians. There is definitely a need for further research in the field, especially regarding major unresolved issues such as the proper selection of patients for whom antidepressants are indicated, clinical and biological predictors of treatment response, and the development of new antidepressants with superior efficacy and safety as well as an earlier onset of action. Meanwhile, an empathic psychotherapeutic alliance coupled with careful clinical and pharmacological monitoring are the essential prerequisites for successful antidepressant treatment.