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Psychopharmacology in crisis

Researchers warn of 'withdrawal of hope' as funding shrivels.

Daniel Cressey

Many people affected by mental illness are facing a bleak future as drug companies abandon research into the area and other funding providers fail to take up the slack, according to a new report.

Produced for the European College of Neuropsychopharmacology (ECNP), the report warns that "research in new treatments for brain disorders is under threat". With current treatments inadequate for many patients, it says, "withdrawal of research resources is a withdrawal of hope for patients and their families"¹.

A number of formerly big players in neuroscience have all but abandoned the area recently as the pharmaceutical industry has undergone massive restructuring. AstraZeneca and GlaxoSmithKline have both cut research funding and closed down entire teams dedicated to developing drugs for psychiatric disorders.

Although some of the problems faced by the field also apply to other sections of the pharmaceutical industry, many are specific to researchers trying to hit targets in the brain.

David Nutt and Guy Goodwin, who authored the report following a recent ECNP meeting on the topic, note that it can take much longer to develop medicines for psychiatric disorders than for better-understood conditions such as cancer, and that potential drugs for psychiatric conditions have higher failure rates. These failures sometimes become apparent only late in the development process, making neuroscience an expensive and risky prospect for industry.

The coming crisis

Nutt, a neuropsychopharmacologist at Imperial College London, told reporters at a press conference in London on 13 June that "these are dark days for brain science".

Both authors add that, in addition to the dearth of pharmaceutical funding, there is still a stigma surrounding conditions such as depression. This feeds through into the money donated to advocacy groups. "Almost nothing" comes from charity groups for mental-health research, compared with huge charity funding in areas such as cancer, notes Goodwin, head of psychiatry at the University of Oxford, UK.

He warns of a "generational crisis" in terms of both training and capacity to develop new drugs for conditions such as depression and dementia, unless the withdrawal of pharmaceutical funding is addressed.

This warning is echoed by an editorial published last week in the British Journal of Clinical Pharmacology (BJCP). 'Vanishing clinical psychopharmacology', written by Joop van Gerven and Adam Cohen of the Leiden University Medical Centre in the Netherlands, outlines the perilous state of the field². Over the past year, the authors write, the BJCP has published only five papers in this area, none of which involved novel drugs.

At the 2011 meeting of the American Society for Clinical Pharmacology and Therapeutics, only 13 of 300 abstracts related to psychopharmacology and, again, none related to novel drugs. This situation mirrored that at the 2010 Collegium Internationale Neuro-Psychopharmacologicum, where 8 of 870 abstracts were on human psychopharmacology and four were on "new or relatively new mechanisms of action", they report.

The road ahead

Cohen says that much of the problem derives from a failure to develop the underlying science. Depression is a complex disease, yet to assess whether drugs work, researchers have to rely on crude tools such as questionnaires.

"People have not paid enough attention to how to measure depression, how to measure psychosis," he says. "When we develop new drugs, we still measure on these basic scales."

Developing new ways of assessing brain function and disease will reduce the risks in developing new drugs, van Gerven and Cohen argue in their editorial.

Nutt and Goodwin also suggest a number of ways forward. Patents could be longer-lived for drugs that take longer to develop, such as those for brain disorders, to encourage companies to work in the area. And researchers should lobby for European funding — such as that available from the Framework programme initiative — to set brain research as a priority.

Academia could also develop more creative relationships with industry in order to fill the gap in drug development, they argue. The ECNP is pushing the idea of a 'medicines chest', to which companies can assign compounds they are no longer actively developing to be taken forward by researchers in academia or elsewhere. Nutt says that several companies have already expressed an interest in this idea.

If the current research base is allowed to evaporate, Nutt warns, it will be decades before it can be built up to start again.