The field of psychopharmacology was born during the 15 years between 1955 and 1970. Now, nearly 60 years later, the field of psychiatry may be at the beginning of a second psychopharmacology revolution.
During the first psychopharmacology revolution, antipsychotics, antidepressants, and antianxiety agents were discovered.
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The field of psychiatry may now be entering a second psychopharmacology revolution. Over the past 20 years, ketamine, a medication already approved as an anesthetic, has been found to have rapid and substantial antidepressant effects when administered intravenously at lower-than-anesthetic doses. Ketamine’s antidepressant effects occur within hours and can last up to a week or more following a single infusion.
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A second major new advance in psychopharmacology involves a group of drugs called neurosteroids (or neuroactive steroids). The structure and function of neurosteroids are very different than either the older antidepressants or ketamine.
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The ketamine-based drugs and the neurosteroid-based drugs are revolutionary in terms of the rapidity of their antidepressant effects and their mechanisms of action. Other medications with truly different mechanisms are also in the early stages of investigation. It is possible that the 15 years between 2015 and 2030 will be as remarkable in terms of psychopharmacology as the 1955-1970 era.
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