Problems with currently available antidepressants

Although options for pharmacologic treatment for depression have grown seemingly exponentially over the past several decades, the current armamentarium of antidepressants continues to have limitations of both efficacy and tolerability. The problems include an unacceptable lack of efficacy, delayed onset of therapeutic effects, an inability to predict responses to one or another agent, drug-drug interactions, and difficulty with tolerability during both acute and chronic treatment. This article reviews the problems that persist in the use of currently available antidepressant medications and presents a list of attributes that would be characteristic of the ideal antidepressant.