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Sunday, 26.03.2017

Reply (Martin Katz)

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It is difficult in a brief commentary to capture the main themes of a book in which the author attempts to rethink the nature of a major mental disorder and evaluate the impact of diverse new drug classesin its treatment. I have Per Bech to thank for grasping my intentions as well as the technical recommendations for changing the direction of research on the mechanisms of action of antidepressants. In linking the results of our experiments to the early ideas of the astute Paul Keilholz on how the drugs work clinically, and to the sequence of neurochemical actions uncovered by Carlsson, he provides a meaningful context for the observation that we are currently approaching research problems in this area in the wrong manner. Depression as Bech, notes from our results, is multidimensional and agrees that we must cease relying so heavily on diagnosis in the structure of research in psychopharmacology. If we adopt the dimensional approach, it will have major effects on how we design clinical trials of new agents.  It will also, hopefully, stimulate experimentation on agents with novel mechanisms, research that will restart development in an area that has uncovered no “new” classes of antidepressant drugs for several decades. Bech with his depth in the field of methodology places our work in the proper context for psychopharmacology and reinforces the need to move ahead in drug discovery with a new concept of depression and a broader range of approaches to behavioral measurement.

Martin M. Katz
November 14, 2013