Scrip's Complete Guide to CNS Disorders

Scrip's Complete Guide to CNS Disorders

Therapeutic

A comprehensive overview of the global market for current and forthcoming CNS drugs, this report covers the major areas: Alzheimer's disease, Parkinson's disease, depression, schizophrenia and anxiety. Six volumes supply you with invaluable information on CNS drugs in R&D and the global market for CNS therapies.

Access:

Extensive R&D information on over 150 products in clinical trials for CNS disorders
R&D details for over 200 drugs in preclinical research
Relative market share of products and sales forecasts to 2002 for each disease
18 top company profiles
Sales figures for the top 30 CNS drugs currently on the market

Each major disease area is covered in a separate volume containing definitions, pathogenesis, risk factors and epidemiology. The report also supplies descriptions of current treatments and information on their advantages and disadvantages.

Profiles of the 18 companies most active in the CNS field allow you to undertake accurate competitor analysis - and evaluate opportunities for strategic collaborations.

PUBLISHED: AUGUST 1999
REF: BS1023E
PAGES: 600+
PRICE: Complete six-volume set �990/$1,995/�238,000

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CONTENTS
LIST OF TABLES
ACKNOWLEDGEMENTS
EXECUTIVE SUMMARY
METHODOLOGY
ABBREVIATIONS
GLOSSARY

CHAPTER 1 INTRODUCTION TO DEPRESSION AND BIPOLAR DISORDER
1.1 Background to depression
1.2 Definition of depression
1.2.1 Reactive or exogenous depression
1.2.2 Unipolar/bipolar or endogenous depression
1.2.3 Depression in the elderly and secondary to other disease
1.2.4 Depression in children and adolescents
1.2.5 Seasonal affective disorder
1.2.6 Depression with co-existent anxiety
1.2.7 Postnatal depression
1.2.8 Premenstrual dysphoric disorder
1.3 Pathogenesis of depression
1.4 Symptoms of depression
1.5 Prognosis
1.6 Aetiology
1.6.1 Risk factors for depressive disorders
1.6.1.1 Genetic
1.6.1.2 Environmental
1.6.1.3 Childhood events
1.6.1.4 Hormonal factors and the stress response
1.6.1.5 Circadian rhythms
1.7 Opportunities for drug intervention in depression
1.8 Epidemiology
1.8.1 Incidence and prevalence
1.9 Bipolar disorder
1.9.1 Pathogenesis of bipolar disorder
1.9.2 Symptoms specific to bipolar disorder
1.9.3 Prognosis
1.9.4 Risk factors for bipolar disorder
1.9.4.1 Genetic
1.9.4.2 Age
1.9.4.3 Environmental
1.10 Opportunities for drug intervention in bipolar disorder
1.11 Epidemiology
1.11.1 Incidence and prevalence
1.12 Trends in treatment and prevention
1.12.1 Trends in treatment for depressive disorders
1.12.2 Trends in treatment for bipolar disorder
1.12.3 Treatments other than drug therapy

CHAPTER 2 MARKETED DRUGS
2.1 Summary of drug classes
2.2 Tricyclic and tetracyclic antidepressants
2.3 Adrenergic agents
2.3.1 Dihydroergocryptine
2.3.2 Lithium
2.4 Serotonergic agents
2.4.1 Selective serotonin reuptake inhibitors
2.4.1.1 Citalopram
2.4.1.2 Fluoxetine
2.4.1.3 Fluvoxamine
2.4.1.4 Paroxetine
2.4.1.5 Sertraline
2.4.2 Compounds with other serotonergic activity
2.4.2.1 Nefazodone
2.4.3 Serotonin and noradrenaline reuptake inhibitors
2.4.3.1 Milnacipran
2.4.3.2 Venlafaxine
2.4.4 Noradrenaline and selective serotonergic antidepressants
2.4.4.1 Mirtazapine
2.5 Noradrenaline reuptake inhibitors
2.5.1 Reboxetine
2.6 Dopaminergic agents
2.6.1 Amisulpride
2.6.2 Lisuride hydrogen maleate
2.7 GABAergic agents
2.7.1 Rilmazafone
2.8 Monoamine oxidase inhibitors
2.8.1 Moclobemide
2.9 Miscellaneous agents
2.9.1 Bupropion
2.9.2 Carbamazepine
2.9.3 Divalproex sodium
2.10 Summary tables
2.11 Opportunities for new drugs
2.11.1 Co-existence of anxiety with depression
2.11.2 Treatment-resistant patients
2.11.3 Demand for fast-onset of action
2.11.4 High relapse/recurrence rates
2.11.5 New recommendations

CHAPTER 3 DRUGS IN DEVELOPMENT
3.1 Summary of antidepressants in development
3.2 Serotonergic agents
3.2.1 Selective serotonin reuptake inhibitors
3.2.1.1 (S)-citalopram
3.2.1.2 Fluoxetine
3.2.1.3 R-fluoxetine
3.2.1.4 Paroxetine
3.2.1.5 YM-922
3.2.2 Compounds with other serotonergic activity
3.2.2.1 Alnespirone
3.2.2.2 DU-125530
3.2.2.3 EMD-68843
3.2.2.4 F-11440 maleate
3.2.2.5 Flesinoxan
3.2.2.6 Flibanserin
3.2.2.7 MKC-242
3.2.2.8 NAD-299
3.2.2.9 Olanzapine
3.2.2.10 OPC-14523
3.2.2.11 Org-12962
3.2.2.12 Robalzotan
3.2.2.13 SB-243213
3.2.2.14 SR-46349
3.2.2.15 Sunepitron
3.2.3 Serotonin and noradrenaline reuptake inhibitors
3.2.3.1 Duloxetine
3.3 Noradrenaline reuptake inhibitors
3.3.1 MCI-225
3.4 Dopaminergic agents
3.4.1 NS-2389
3.4.2 Pramipexole
3.5 Phosphodiesterase inhibitors
3.5.1 Rolipram
3.6 Monoamine oxidase inhibitors
3.6.1 Befloxatone
3.6.2 KP157
3.7 Corticotrophin-releasing factor compounds
3.7.1 NBI-103
3.7.2 NBI-30775
3.8 Melatonin products
3.8.1 IPA
3.8.2 Melatonin
3.9 Substance-P antagonists
3.9.1 MK-869
3.10 AMPAkines
3.11 Miscellaneous agents
3.11.1 E-5505
3.11.2 GW-273293X
3.11.3 Hypericum perforatum
3.11.4 Igmesine hydrochloride
3.11.5 INN-835
3.11.6 Lamotrigine
3.11.7 LX-101b
3.11.8 LX-105
3.11.9 Montirelin
3.11.10 YKP10A
3.12 New approaches

REFERENCES

LIST OF TABLES
Table 1.1 Incidence and prevalence figures for unipolar major depression in different regions worldwide, 1995
Table 1.2 Incidence and prevalence figures for unipolar major depression in areas with different levels of development worldwide, 1995
Table 1.3 Incidence and prevalence figures for unipolar major depression in males and females worldwide, 1995
Table 1.4 Incidence and prevalence figures for unipolar major depression in different age groups worldwide, 1995
Table 1.5 Incidence and prevalence figures for bipolar disorder in different regions worldwide, 1995
Table 1.6 Incidence and prevalence figures for bipolar disorder in areas with different levels of development worldwide, 1995
Table 1.7 Incidence and prevalence figures for bipolar disorder in males and females worldwide, 1995
Table 1.8 Incidence and prevalence figures for bipolar disorder in different age groups worldwide, 1995

Table 2.1 Summary of marketed antidepressant drug classes
Table 2.2 Summary of companies marketing antidepressants
Table 2.3 Summary of companies marketing drugs for depressive disorders whose first indication is not as an antidepressant
Table 2.4 Summary of companies marketing antidepressants specifically indicated for bipolar disorder

Table 3.1 Summary of registered antidepressants and those awaiting registration
Table 3.2 Summary of antidepressants in clinical development for depressive disorders
Table 3.3 Summary of drugs in clinical development for depressive disorders whose first indication is not as an antidepressant
Table 3.4 Summary of antidepressants in preclinical development
Table 3.5 Summary of compounds in clinical development specifically for bipolar disorder

This volume, Depression and Bipolar Disorder, is part of a series forming Scrip's Complete Guide to CNS Disorders. The other volumes in this series are:
Volume 1: Market Overview (BS1024)
Volume 2: Alzheimer's Disease and Other Dementias (BS1025)
Volume 3: Parkinson's Disease (BS1026)
Volume 5: Schizophrenia and Other Psychoses (BS1028)
Volume 6: Anxiety (BS1029)

EXECUTIVE SUMMARY
Estimated to affect up to 50% of the population at some time in their lives, depression is a common problem in all age groups that sometimes results in suicide. Antidepressants are estimated to account for 47% of the worldwide psychiatric-related drug sales, by far the largest market sector. The worldwide market for antidepressants was approximately $7.1 billion in 1997 and is predicted to reach $15 billion in 2002. This market doubling may reflect the anticipated changes in treatment - from generic tricyclic antidepressants (TCAs) which have declining sales but are still widely used, to newer compounds.

The selective serotonin reuptake inhibitors (SSRIs) currently dominate the European Union and US markets and have now also reached Japan. They have proved successful due to fewer side effects than TCAs but they are more expensive; there is still a gap in the market for a fast-acting antidepressant.

Many SSRIs are also gaining additional indications for anxiety; drugs targeting both disorders could benefit because of the increase in diagnosis of depression with co-existent anxiety. Interest may focus on agents found to have a very specific receptor activity, as certain receptors are believed to represent a common link between depression and anxiety. Furthermore, a new strategy for treatment-resistant depression is in development that involves prescribing an antidepressant in combination with an antipsychotic. It is expected that this combinational approach could treat up to 30% of non-responsive depressed patients.

New strategies include reversible monoamine oxidase inhibitors as opposed to the older style irreversible products. The dual-acting serotonin and noradrenaline compound, venlafaxine (Effexor), has provide a successful alternative method for treating more severe cases of depression. In addition, noradrenaline reuptake inhibitors and noradrenaline and specific serotonin reuptake inhibitor compounds have also been released.

Other new developments include melatonin compounds; substance-P antagonists; corticotrophin-releasing factor compounds; single isomer versions of well established SSRIs; herbal remedies; the novel drug class - AMPAkines; thyrotrophin-releasing hormone and sigma-receptor agonists.

Bipolar disorder is a separate market that is expanding as attempts to improve the mainstay treatment - lithium - progress. Characterised by periods of depression and mania, both antidepressants and antipsychotics have an important role in drug treatment. Following the success of divalproex sodium (Depakote), the potential for anticonvulsants in treating bipolar disorder is now being realised with the late stage development of lamotrigine (Lamictal).