NEUROENDOCRINE MARKERS - ROLE IN THE DEVELOPMENT OF ANTIDEPRESSANTS

The suggestion that neuroendocrine studies are of benefit in the devel opment of antidepressant drugs may, at first glance, seem strange. How ever, with the escalating cost of developing new drugs and the necessi ty to produce agents that are an improvement on both the tricyclic ant idepressants and the selective serotonin (5-hydroxytryptamine; 5-HT) r euptake inhibitors, neuroendocrine studies may provide some assistance . In the development of compounds that target traditional monoamine sy stems such as serotonin and noradrenaline (norepinephrine), neuroendoc rine studies can simplify the process of determining the biological po tency of a new compound in humans. This may decrease the necessity for expensive dose-ranging studies in depressed patients. In addition, th e hypothalamic-pituitary-adrenal axis has been suggested as a novel si te for antidepressant drug development. In depressive illness signific ant overactivation of the axis has been described. A number of studies making use of cortisol synthesis inhibitors have now been published a nd both corticotrophin-releasing factor and arginine vasopressin antag onists have been developed. These new approaches to the pharmacologica l management of depression may have advantages over traditional monoam ine reuptake inhibitors, and the results of placebo-controlled studies are awaited with interest.