Emerging treatments for depression.

Established treatments for depression are often effective. However, a significant number of patients show limited or no response. With advancements in the explanation of the underlying neurobiology of depression, several novel therapeutic approaches have been developed. Emerging drug targets include novel monoamine oxidase inhibitors, triple monoamine re-uptake inhibitors, omega-3 fatty acids, melatoninergic agonists and receptor antagonists for corticotropin-releasing factor(1), glucocorticoid, substance-P and NMDA. Developments in therapeutic focal brain stimulation include vagus nerve stimulation, transcranial magnetic stimulation, magnetic seizure therapy and deep brain stimulation. The role of psychotherapy, both as monotherapy and as adjunctive therapy, is an active avenue of investigation. Although data on these treatments are limited, preliminary results are encouraging. A major goal that remains to be achieved is the identification of predictors of response to the various antidepressant treatments that have diverse mechanisms of action.