确保负担得起的东西变得可以获得的 - - 凯胺的教训,这是治疗严重抑郁症的新方法
Anthony Rodgers1, Dilara Bahceci1, Christopher G Davey2
1The George Institute for Global Health, University of New South Wales, Newtown, NSW, Australia.
The Australian and New Zealand journal of psychiatry
|October 13, 2023
概括
通用胺显示严重抑郁症的承诺,但商业化挑战延迟了获取. 改革是必要的,以确保负担得起,有效的治疗,特别是即将到来的迷幻疗法.
科学领域:
- 药理学 药理学是指药理学的学科.
- 精神病学是一个精神病学.
- 卫生经济学 卫生经济学
背景情况:
- 基因基他胺的抗抑郁作用在20多年前就被发现了.
- 商业激励措施不足阻碍了通用胺的注册和评估.
- 专利配方如斯普拉瓦托 (埃斯基他胺) 经过大量投资开发,导致高成本.
研究的目的:
- 概述使用胺作为案例研究,重新利用已知药物的挑战.
- 建议潜在的解决方案,使重新使用的药物更容易获得.
- 突出经济和监管障碍,以获得有效的抑郁症治疗.
主要方法:
- 对重度抑郁症的胺重用进行案例研究分析.
- 对药物批准的商业和监管途径的审查.
- 一般基因与专利胺配方的经济分析.
- 讨论药物可获得性的系统性改革.
主要成果:
- 由于缺乏激励,通用胺的评估被推迟了,而专利的胺被批准,价格显著更高 (600 - 900美元/剂量 vs ~ 5美元/剂量).
- 专利配方的高成本限制了患者的获取,正如澳大利亚政府拒绝资助的情况所示.
- 有证据表明,通用胺药和斯普拉瓦托药一样有效,但尚未进行比较试验.
结论:
- 胺案例说明了药物重新利用的系统性问题,可能会在迷幻药物辅助疗法中重复.
- 迫切需要进行改革,包括商业激励,公共资金和减少监管障碍.
- 确保获得负担得起,有效的治疗方法需要在翻译研究和药物开发中协调努力.
更多相关视频
04:29Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
Published on: January 7, 2019
28.6K
09:07Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
Published on: August 15, 2017
12.1K
相关概念视频
01:30Electroconvulsive Therapy
48
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
48
01:26Psychosis: Goals of Pharmacotherapy
146
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
146
01:28Drug Therapy
49
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
49
01:24Parenteral Anesthetics: Overview
137
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
137
01:23Antidepressant Drugs: MAOIs and Other Agents
256
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
256
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
184
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
184