Abstract
Current medication for depression is inadequate and far from ideal. Development of novel antidepressant drugs is a pressing task. The discovery of ketamine and related agents represents a new era in drug discovery for the rapid treatment of depression. Due to potential neurotoxicity, short-lasting efficacy, the limitation of a single target approach, and a limited role in depression prevention of these agents, additional approaches or drugs that exert synergy and compatibility, with the rapid-acting agents are required for better treatment of depression. Traditional Chinese Medicine (TCM) is a systems medicine and its clinical experience and integrated theory for diagnosis and treatment provides an alternative method of novel drug discovery in depression treatment. In TCM, there are numerous claimed effective antidepressant formulas, but comprehensive research and evidence-based clinical studies are required for their acceptance as a treatment. In this essay, we review current attempts in the discovery of new agents, TCM drug formulation, and TCM treatment of depression, and discuss the challenges and opportunities of TCM in the new era of antidepressant discovery. TCM could provide an important resource in the discovery of novel agents, assistance of the rapid-acting antidepressants, development of new agents for female patients, and the prevention of depression at its early stages. The study of depression in conjunction with TCM therefore not only provides an opportunity to scientifically evaluate the benefits and risks of TCM, but also accelerates the development of novel antidepressant agents by combining the principle of modern molecular medicine with the ideas of empirical systems medicine.
Highlights
Depression is a chronic, recurrent, potentially life-threatening mental illness that affects approximately 15–20% of the global population (Manji et al, 2001; Charney, 2004) and it is thought to be caused by a complex interplay of genetic vulnerabilities and unfavorable environmental events
A systems biology-orientated healing approach to this problem may exist in Traditional Chinese Medicine (TCM)
Great efforts have been made to scientifically elucidate these formulas, our understanding of their mechanism of action, bioactive constituents, and pharmacology of synergy and compatibility of formulation, remains at a rudimentary level. When facing this challenge in the new era of antidepressant discovery, we wonder what can be learnt from ancient systems medicine in antidepressant discovery and how can empirical TCM be integrated into mainstream research, in the neuropharmacology of depression treatment? Here, we discuss future research directions and the possible role of TCM in the treatment of depression
Summary
Reviewed by: Na Yue, Fudan University, China Zengliang Jin, Capital Medical University, China Li-Tao Yi, Huaqiao University, China. Traditional Chinese Medicine (TCM) is a systems medicine and its clinical experience and integrated theory for diagnosis and treatment provides an alternative method of novel drug discovery in depression treatment. We review current attempts in the discovery of new agents, TCM drug formulation, and TCM treatment of depression, and discuss the challenges and opportunities of TCM in the new era of antidepressant discovery. TCM could provide an important resource in the discovery of novel agents, assistance of the rapid-acting antidepressants, development of new agents for female patients, and the prevention of depression at its early stages. The study of depression in conjunction with TCM provides an opportunity to scientifically evaluate the benefits and risks of TCM, and accelerates the development of novel antidepressant agents by combining the principle of modern molecular medicine with the ideas of empirical systems medicine
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