Something's got to give: psychiatric disease on the rise and novel drug development on the decline

Research and development of drugs for psychiatric disease is currently in a state of decline. Despite the increasing prevalence and healthcare costs of psychiatric disease, the costly and unpredictable drug development process has led to decreased public and investor confidence in the abilities of companies to develop safe and efficacious drugs. Industrial research in this disease area is therefore being scaled back owing to various scientific, corporate, financial and legal factors. This review will consider how these factors contribute to the current status of psychiatric drug development and offer several avenues forward to spur reinvestment in this type of research. Such a shift is needed to reduce the burden psychiatric disease imposes on the healthcare system and its patient populations.

► Costly and unpredictable drug discovery process reduces investment for psychiatric indications.
► Unidentified pathophysiology for psychiatric disease prevents hypothesis driven research.
► Lack of biomarkers and poor disease modeling hinder the drug development process.
► Placebo effect reduces ability to detect symptomatic improvement from therapeutic intervention.
► Changes in corporate culture and regulation, and more basic research will reverse these trends.