Novel strategies for pharmacotherapy of depression

Modulating monoamine activity as a therapeutic strategy continues to domina te antidepressant research, with a recent emphasis on agents with multiple targets, including combined serotonin/noradrenaline re-uptake inhibitors an d numerous serotonin receptor ligands. An important new development has bee n the emergence of potential novel mechanisms of action, notably modulation of the activity of neuropeptides substance P and corticotrophin-releasing factor, and the intracellular messenger cyclic adenosine monophosphate. Eff orts in this area have recently been rewarded by the demonstration of antid epressant efficacy of the substance P receptor antagonist MK-0869.