ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2023
The future of psychopharmacology: a critical appraisal of ongoing phase 2/3 trials, and of some current trends aiming to de-risk trial programmes of novel agents.
Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Strategies for Switching between Oral Postsynaptic Antidopaminergic Antipsychotics in Patients with Schizophrenia: A Systematic Review.CNS drugs · 2025Pooled it
- Trajectory of efficacy and safety across ulotaront dose levels in schizophrenia: a systematic review and dose-response meta-analysis.The international journal of neuropsychopharmacology · 2025Pooled it
- Nutraceuticals and phytoceuticals in the treatment of schizophrenia: a systematic review and network meta-analysis "Nutra NMA SCZ".Molecular psychiatry · 2025Pooled it
- Placebo effects in randomized trials of pharmacological and neurostimulation interventions for mental disorders: An umbrella review.Molecular psychiatry · 2024Pooled it
- Predictors of benefits and safety events from participation in a lifestyle therapy trial for adults with depression: A secondary analysis of the CALM randomised controlled trial.The Australian and New Zealand journal of psychiatry · 2026Trial
- Efficacy and safety of zuranolone in Japanese adults with major depressive disorder: A double-blind, randomized, placebo-controlled, Phase 3 clinical trial.Psychiatry and clinical neurosciences · 2026Trial
- Azetukalner, a Novel KV7 Potassium Channel Opener, in Adults With Major Depressive Disorder: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Placebo Effects Are Small on Average in the 7.5% CO2 Inhalational Model of Generalized Anxiety.The international journal of neuropsychopharmacology · 2024Trial
- Child and adolescent psychiatry: challenges, solutions, opportunities, and future directions.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Real-world comprehensive care of people living with schizophrenia: recommendations across different settings and clinical stages.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- A Time-Sensitive Plasticity Distinguishes the Rapid and Sustained Synaptic Actions of Ketamine from Its (2The Journal of neuroscience : the official journal of the Society for Neuroscience · 2026Article
- Why is schizophrenia a huge graveyard of molecules?Schizophrenia (Heidelberg, Germany) · 2025Article
- Recent Advances in Psychopharmacology.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Placebo and nocebo phenomena in schizophrenia spectrum disorders: a narrative review on current knowledge and potential future directions.Psychological medicine · 2025Review
- Effect ofPharmaceuticals (Basel, Switzerland) · 2025Article
- A roadmap for better and personalized mental health care in Europe - the action plan of the European Psychiatric Association.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Glutamate-Based Therapeutic Strategies for Schizophrenia: Emerging Approaches Beyond Dopamine.International journal of molecular sciences · 2025Review
- Funding Trends in Japan Agency for Medical Research and Development (AMED): Focus on Psychiatry.JMA journal · 2025Review
- Continuous Dopamine DThe American journal of psychiatry · 2025Article
- PSY-PGx: a new intervention for the implementation of pharmacogenetics in psychiatry.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 9 institutions in 5 countries.
Funding
Abstract
Despite considerable progress in pharmacotherapy over the past seven decades, many mental disorders remain insufficiently treated. This situation is in part due to the limited knowledge of the pathophysiology of these disorders and the lack of biological markers to stratify and individualize patient selection, but also to a still restricted number of mechanisms of action being targeted in monotherapy or combination/augmentation treatment, as well as to a variety of challenges threatening the successful development and testing of new drugs. In this paper, we first provide an overview of the most promising drugs with innovative mechanisms of action that are undergoing phase 2 or 3 testing for schizophrenia, bipolar disorder, major depressive disorder, anxiety and trauma-related disorders, substance use disorders, and dementia. Promising repurposing of established medications for new psychiatric indications, as well as variations in the modulation of dopamine, noradrenaline and serotonin receptor functioning, are also considered. We then critically discuss the clinical trial parameters that need to be considered in depth when developing and testing new pharmacological agents for the treatment of mental disorders. Hurdles and perils threatening success of new drug development and testing include inadequacy and imprecision of inclusion/exclusion criteria and ratings, sub-optimally suited clinical trial participants, multiple factors contributing to a large/increasing placebo effect, and problems with statistical analyses. This information should be considered in order to de-risk trial programmes of novel agents or known agents for novel psychiatric indications, increasing their chances of success.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.