[World trends of new drug development for major affective disorders]

No antimanic substance has been developed since lithium was introduced. There seem to be some anticonvulsant drugs which are considered to possess certain mood stabilizing effects similar to carbamazepine. There are a number of new compounds which are effective for depressed mood and induce a lower incidence of anticholinergic and cardiotoxic reactions than tricyclic antidepressants. Selective 5-HT reuptake inhibitors (SSRI) have been studied and some products have been launched in Europe and the US, but they are still under development in Japan. Selective and reversible MAO-A inhibitors may have an improved therapeutic effect. Other receptor agonists and antagonists may be usable in depressed patients who are resistant to, or intolerant of, other antidepressant therapy.