Session 1: Delivering at the Molecular Level
Despite depression being a leading cause of disability, genuinely new medicines have been rare for decades, with most approvals representing incremental shifts on familiar monoaminergic themes. Recent rapid-acting glutamatergic advances offer a needed spark of optimism: esketamine demonstrates that alternative biology approaches can translate to clinical benefit.
On the horizon, next-generation approaches aimed at synaptic plasticity, including AMPA receptor positive allosteric modulators (AMPAR PAMs), are beginning to test whether rapid antidepressant effects can be delivered more broadly. Achieving this requires a long, iterative journey from understanding to trials - target validation, translational models, biomarkers, safety margins, and study design - and a long funding journey involving a relay between academia, big pharma, and biotech, and financed across public, charity, venture, and market contexts.