How will we get novel medicines in psychiatry? Lessons from schizophrenia

The talk will first give an overview of drug approvals over the last decade and compare the number of approvals for novel mechanisms in psychiatry with other areas of medicine. This shows there have been few medicines with novel mechanisms approved in psychiatry. This not for want of trying. In schizophrenia, for example, >50,000 patients have taken part in clinical trials of new drugs. Some of the limitations of the current medicine development paradigm will be considered using schizophrenia as an example. The talk will then consider findings on the dopaminergic neurobiology of schizophrenia and their implications for developing novel treatments, including the specificity to particular symptoms and the potential for targeting trace amine receptors. Finally it will consider the latest translational neuroscience on the role of aberrant cortical synaptic pruning in schizophrenia and the potential for disease modification.