Fundamental and clinical neuropharmacology, a terra incognita with constantly expanding frontiers

Abstract

Neuropharmacology is the science that studies the effects of drugs on the central nervous system. Examining the recent history of neuropharmacology allows us to identify future challenges and to project into the future. The contemporary history of neuropharmacology begins with the empirical use of psychotropic alkaloids in barbiturate preparations. Then the discovery of neuroleptics in the 1950s truly opened up the field of pharmacological science, with psychopharmacological clinical exploration in psychiatry, complemented by the contributions of neurochemists and biochemists discovering and exploring neurotransmission. These studies also contributed to the development of dopaminergic and serotonergic drugs used in neurology. The more recent period brought the advent of neuropsychopharmacology, sharing therapeutic targets in neurology and psychiatry on the one hand, and a translational research approach on the other. Moreover, the pharmacology of brain drugs is still a growing discipline in 2020. Despite emerging pharmacological concepts (biased agonists, glial targeting, epigenetic therapeutics, etc.), entire areas of brain‐based therapeutics need to be renewed, particularly in psychiatry, offering great challenges to a new generation of pharmacologists and clinicians.

Key Characteristics and Development of Psychoceuticals: A Review

“…The neurological and psychiatric pharmacology fields have grown immensely since the 19th century and have brought considerable benefits to managing and treating various illnesses. For example, the introduction of morphine as well as other medications that induced sedation for the rapid control of agitation and aggression in psychiatric hospitals during the second half of the 19th century [ 1 , 2 ] sparked research into pharmacotherapeutic interventions for neurologic and mental health illnesses. By the late 1950s, the discovery of six different central nervous system (CNS) neurotransmitters (acetylcholine, dopamine, GABA, norepinephrine, serotonin, and substance P) allowed the development of pharmacotherapeutic treatments for neurological conditions, such as Parkinson’s disease, and psychiatric conditions, such as depression and schizophrenia [ 1 , 2 ].…”

“…The current state of psychoceutical innovation has remained motionless for a long time. Many of the drugs within this class used today were discovered more than 70 years ago [ 2 , 3 ]. Various factors surrounding the research and trial testing of psychoceuticals have kept the development of these drugs from moving forward.…”

“…Various factors surrounding the research and trial testing of psychoceuticals have kept the development of these drugs from moving forward. Some examples are limited pathophysiological knowledge [ 2 , 3 ], high rates of failure in phase III trials, poor predictive animal models [ 2 ], later returns of investment, and high costs of drug development [ 4 , 5 ], among others. These factors negatively impact the development of new medications in this class, yet the most important one is the shift of charge from clinical researchers to the pharmaceutical industry.…”

“…Currently, the psychoceuticals available in the global market are accompanied by multiple side effects and have response rates of less than 50% [ 2 ]. To see a positive change in neurological and psychiatric pharmacotherapy, the clinical research community must support the moral development of novel drugs within those fields.…”