| New antidepressant development, until fairly recently, | | | | There were very few ways of knowing the answers |
| was at best a random, and at worst a problematic | | | | to those two questions about any given compound |
| and frustrating, process. Often, medications that | | | | unless you tried it, a process not without its obvious |
| were developed for one thing were discovered quite | | | | risks. It should be noted that vagus nerve stimulation |
| accidentally to have much more important therapeutic | | | | for depression clearly meets the two main FDA |
| effects for a completely different disorder. It has | | | | requirements of safety and efficacy. |
| been well described that some of the original | | | | Medications to treat depression; mild, severe, bipolar, |
| antipsychotics were originally developed to assist in | | | | or treatment-resistant, make the news most |
| anesthesia, and some of the original new | | | | frequently, and deservedly so. Their progress and |
| antidepressants were originally intended to be | | | | approval can potentially benefit almost 8 million |
| medications for tuberculosis or psychosis. New | | | | Americans who suffer from some form of |
| antidepressant development was done on a | | | | depression. Because there seems to be more |
| "chemical" basis; that is, guesses were made as to | | | | frequency now of depression that is |
| compounds that would be safe and effective based | | | | treatment-resistant, meaning most methods of |
| on chemical structures of established medications. | | | | treatment (medications, psychotherapy, |
| This was very much a trial-and-error process, since | | | | electroconvulsive therapy, or a combination of more |
| very little was known about how these drugs | | | | than one treatment) have failed for a patient, the |
| worked and very little could be measured beyond | | | | approval of new antidepressants from companies like |
| actually giving them to a patient. | | | | Merck, Lilly, and Pfizer, are more important than ever. |
| New antidepressant development always has been | | | | This is because a new class of medication for |
| and always will be a partnership between efficacy (ie, | | | | treating depression has not been developed in over a |
| whether the drug is effective) and safety (ie, | | | | decade. |
| whether the drug can be tolerated by a patient). | | | | |