List of investigational antidepressants
This is a list of investigational antidepressants, or antidepressants that are currently under development for clinical use in the treatment of mood disorders but are not yet approved. Chemical/generic names are listed first, with developmental code names, synonyms, and brand names in parentheses. All drugs listed are specifically under development for major depressive disorder (MDD) and/or treatment-resistant depression (TRD) unless noted otherwise. Other forms of depression may include bipolar depression and postpartum depression.
Glutamatergics
NMDA receptor modulators
- 4-Chlorokynurenine (AV-101) – NMDA receptor glycine site antagonist[1]
- Apimostinel (GATE-202, NRX-1074) – NMDA receptor modulator[2]
- Arketamine (PCN-101, HR-071603) – unknown mechanism of action, indirect AMPA receptor activator[3][4]
- Esketamine (Esketamine DPI, Falkieri, PG061) – non-competitive NMDA receptor antagonist – approved for TRD, specifically under development for bipolar depression and "depressive disorders"
- Esmethadone (dextromethadone; REL-1017) – NMDA receptor antagonist open channel blocker[5]
- Ketamine (PMI-100, PMI-150, R-107, SHX-001, SLS-002; TUR-002) – non-competitive NMDA receptor antagonist[6]
- MIJ-821 – NMDA receptor subunit 2B (NR2B) negative allosteric modulator
- Rislenemdaz (CERC-301, MK-0657) – NMDA receptor NR2B antagonist[7]
AMPA receptor modulators
- TAK-653 (NBI-1065845) – AMPA receptor positive allosteric modulator
Monoaminergics
Monoamine reuptake inhibitors
- OPC-64005 – serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI)
- PDC-1421 (BLI-1005) – norepinephrine reuptake inhibitor (NRI)[8]
- Toludesvenlafaxine (ansofaxine; LY03005, LPM570065) – SNDRI[9]
Monoamine reuptake inhibitors and receptor modulators
- Hypidone (YL-0919) – SRI, 5-HT1A receptor partial agonist, and 5-HT6 receptor agonist
- TGBA01AD (FKB01MD) – serotonin reuptake inhibitor (SRI), 5-HT1A and 5-HT1D receptor agonist, and 5-HT2 receptor antagonist[10]
- Vortioxetine (Trintellix) – SRI, 5-HT1A receptor agonist, 5-HT1B receptor partial agonist, 5-HT1D, 5-HT3, and 5-HT7 receptor antagonist – approved for MDD, under development for bipolar depression
Monoamine releasing agents
- Lisdexamfetamine (Elvanse, LDX, NRP-104, S-877489, SHP-489, SPD-489, Tyvense, Venvanse, Vyvanse) – norepinephrine–dopamine releasing agent (NDRA)
- Midomafetamine (MDMA; ecstasy) – serotonin–norepinephrine–dopamine releasing agent (SNDRA)
Monoamine receptor modulators
- Aramisulpride/esamisulpride (85:15 ratio) (SEP-4199) – 5-HT7 receptor antagonist (aramisulpride) and D2 and D3 receptor antagonist (esamisulpride) – specifically under development for the treatment of bipolar depression[11][12]
- Gepirone (TGFK07AD; Travivo) – 5-HT1A receptor partial agonist[13]
- Pramipexole (CTC-501, CTC-413) – D2, D3, and D4 receptor agonist[14][15]
- Psilocybin – 5-HT2A receptor agonist[16]
Atypical antipsychotics
- Brilaroxazine (RP-5063, RP-5000) – AA – specifically under development for the treatment of MDD[17]
- Cariprazine (Reagila, Vraylar) – AA – approved for bipolar depression, under development for MDD
- Lumateperone (ITI-007) – AA – specifically under development for the treatment of MDD and bipolar depression[18]
- Lurasidone (Latuda) – AA – specifically under development for the treatment of MDD
- Pimavanserin (Nuplazid; ACP-103; BVF-048) – 5-HT2A receptor antagonist – specifically under development for the treatment of MDD[19]
Others
- Ademetionine (SAMe; MSI-190, MSI-195, Strada) – cofactor in monoamine neurotransmitter biosynthesis – specifically under development in the United States and Europe for the adjunctive treatment of MDD[20]
GABAergics and neurosteroids
GABAA receptor positive modulators
- PRAX-114 – GABAA receptor positive allosteric modulator
- Zuranolone (SAGE-217) – GABAA receptor positive allosteric modulator – specifically under development for the treatment of MDD and postpartum depression[21]
Others
- 3β-Methoxypregnenolone (MAP-4343) – selective microtubule-associated protein 2 (MAP2) stimulant[22]
- Itruvone (PH-10) – vomeropherine (precise mechanism of action unknown/undisclosed)[23]
Opioidergics
κ-Opioid receptor antagonists
- Aticaprant (JNJ-67953964, CERC-501, LY-2456302) – selective κ-opioid receptor antagonist[24]
- BTRX-335140 (BTRX-140) – selective k-opioid receptor antagonist[25][26]
- Buprenorphine/samidorphan (ALKS-5461) – κ-opioid receptor antagonist and μ-opioid receptor antagonist[27]
Nociceptin receptor antagonists
- BTRX-246040 (LY-2940094) – nociceptin receptor antagonist[28]
Cholinergics
Muscarinic acetylcholine receptor modulators
Others
- OnabotulinumtoxinA (botulinum toxin A, Botox) – acetylcholine release inhibitor – specifically under development for the treatment of MDD in women as a local injection to paralyze facial muscles[29]
Orexin receptor antagonists
- JNJ-61393215 (JNJ-3215; Orexin-1) – OX1 receptor antagonist[30][31]
- Seltorexant (MIN-202, JNJ-42847922, JNJ-922) – OX2 receptor antagonist[32]
Others
- BI-1358894 – TRPC4 and TRPC5 inhibitor
- Crisdesalazine (AAD-2004) – MPGES-1 inhibitor
- Erteberel – selective ERβ receptor agonist
- JNJ-54175446 – P2RX7 purinoceptor antagonist[33]
- NSI-189 – hippocampal neurotrophic agent (precise mechanism of action unknown)[34]
- NV-5138 – sestrin2 modulator and consequent mammalian target of rapamycin complex 1 (mTORC1) activator[35][36][37]
- SNG-12 – undefined mechanism of action
- TS-121 – vasopressin 1B receptor antagonist[38]
- WIP-DF17 – undefined mechanism of action
- XEN1101 - KCNQ2/3 channel opener [39]
Mixed
- Tramadol (ETS6103; Viotra) – μ-opioid receptor agonist, serotonin–norepinephrine reuptake inhibitor (SNRI) and possible serotonin releasing agent (SRA), 5-HT2C receptor antagonist, and other actions[40][41][42]
Combinations
- Carbidopa/oxitriptan (EVX-101) – serotonin precursor and aromatic L-amino acid decarboxylase inhibitor
- Cycloserine/lurasidone (NRX-101; Cyclurad) – NMDA receptor glycine site partial agonist and AA combination – specifically under development for the treatment of bipolar depression[43]
- Deudextromethorphan/quinidine (AVP-786, CTP-786) – σ1 receptor agonist, SRI, uncompetitive NMDA receptor antagonist, and other actions[44]
Not under development
The following notable drugs are of investigational interest as potential antidepressants but are not formally under clinical development for approval at this time:
- Hydroxynorketamine ((2R,6R)-HNK) – metabolite of ketamine which may be involved in ketamine's antidepressant-like effects in mice[3][45]
- Minocycline – microglia inhibitor and other actions; a 2018 systematic review and meta-analysis reported that the overall antidepressant effect size of minocycline compared to placebo was -0.78 (95% CI: -0.4 to -1.33, P=0.005), indicative of a large and statistically significant antidepressant effect[46][47]
- Nitrous oxide – NMDA receptor antagonist and other actions[48][49][50]
- R13 – an orally active prodrug of tropoflavin with improved pharmacokinetics[51]
- Tropoflavin (7,8-dihydroxyflavone; 7,8-DHF) – TrkB agonist[52][53][54][55][56][57][58][59]
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Further reading
- Ionescu DF, Papakostas GI (March 2017). "Experimental medication treatment approaches for depression". Translational Psychiatry. 7 (3): e1068. doi:10.1038/tp.2017.33. PMC 5416676. PMID 28323287.
- Garay RP, Zarate CA, Charpeaud T, Citrome L, Correll CU, Hameg A, Llorca PM (June 2017). "Investigational drugs in recent clinical trials for treatment-resistant depression". Expert Review of Neurotherapeutics. 17 (6): 593–609. doi:10.1080/14737175.2017.1283217. PMC 5418088. PMID 28092469.
- Dhir A (January 2017). "Investigational drugs for treating major depressive disorder". Expert Opinion on Investigational Drugs. 26 (1): 9–24. doi:10.1080/13543784.2017.1267727. PMID 27960559. S2CID 45232796.
External links
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