Novel Treatments for MDD and TRD

As psychiatry and mental health treatment evolves, newer treatments in development will target new centers of the brain and use novel mechanisms of action to aid in the treatment of disease states like bipolar disorder, major depressive disorder (MDD), and treatment-resistant depression (TRD). Ahmed Baig, MD, chief medical officer at Midwest Research Group, is part of a team currently working to create these novel treatments, and, in an interview with Psych Congress Network, Dr Baig shared his research, new mechanisms of action, and what these therapies mean for depression treatment

For more insights on treating major depressive disorder from the industry's experts, check out our Major Depressive Disorder Excellence Forum.

Stay tuned for part 2. 

Read the transcript:

Psych Congress Network: Can you share a few novel treatments for MDD that your team is currently investigating in clinical trials? What about TRD?

Ahmed Baig, MD: Sure. There's been an exciting transformational change in our understanding of the underlying mechanisms of depression and consequently how we treat it.

Instead of the previous monoamine hypothesis for the past 16 years, which focused on modulating serotonin, dopamine, and norepinephrine, more recently, the research points to the underlying pathology of depression being related to the dysregulation or imbalance of the GABA and glutamate pathway.

The newer treatments that are being developed, and that we are currently studying, target those various intracellular signaling pathways that are involved in the GABA and glutamate pathways with the end goal being of restoring the normal balance in those neuro metabolites.

So, specifically some of the novel medications that are being studied right now and that we are involved in running clinical trials, there's a drug for modulating AMPA, a G-protein couple receptor agonist, mTOR. SAGE has a neuro-steroid that we did a study on, and really promising results a couple of years ago, and should come to market in a few months. And the kappa opioid receptor.

In addition to these newer targets, which make them more rapid-acting, they have a far less problematic side effect profile. The medications are also being studied. They have various dosing intervals. So, one of those medications is a once-weekly medication. One of those medications, the SAGE compound, you do 2-week treatment cycles, and re-treatment is based on recurrence of symptoms.

And thankfully, several of those medications that I mentioned are being specifically evaluated for treatment and treatment-resistant depression. And as everyone knows, treatment-resistant depression patients are particularly at higher risk. And unfortunately, we've had a real lack of meaningful and effective treatments for that patient population.

But thankfully, a lot of the newer medications are being specifically developed to get more meaningful improvement in those patients. And I can tell you firsthand, we've seen really amazing results in kind of restoring function and quality of life for those patients.

Ahmed Baig, MD, is chief medical officer at Midwest Research Group and trained at Saint Louis University School of Medicine. He has been involved in clinical research trials for the past 10 years and over 40 clinical studies. Currently, under the direction of primary investigator Dr Greg Mattingly, Dr Baig and Midwest Research Group are conducting several clinical trials for novel therapeutics in the treatment of MDD and TRD, bipolar disorder, ADHD, and schizophrenia.