In 2001 CNS therapies held a market share worth in excess on $40 billion- the strongest growth of any therapeutic class with a staggering 17 percent.
In the US, drug therapies for CNS lead the pack where prescription drugs expenditure is concerned, with therapies holding a market size of more than $28 billion ($4 billion more than its closets competitor).
If you are part of this market then you need to increase your share. Is the answer the future pharmaceutical management of the most prominent CNS disorders in the exploitation of novel mechanisms which have previously eluded the R&D world, or is it in the intelligent use of those products which are currently available - and if so, what might the impact be on those companies involved?
CNS 2002 by visiongain provides the reader with up-to-date listings of the current pipelines for the leading companies engaged in the R&D into the treatment of CNS disorders, as well as detailed drug profiles of the therapies currently available and their application in the future treatment of prominent CNS disorders.
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Table of contents
1. Introducing the CNS Market
1.1 An Overview of Mental Health in the US and Developed World
1.2 Classification of Mental Illness
1.2.1 Organic, including symptomatic, mental disorders
1.2.2 Mental and behavioural disorders due to psychoactive substance use
1.2.5 Schizophrenia, schizotypal and delusional disorders
1.2.4 Mood (affective) disorders
1.2.5 Neurotic, stress-related and somatoform disorders
1.2.6 Behavioral syndromes associated with physiological disturbances and physical factors
1.2.7 Disorders of adult personality and behavior
1.2.8 Mental retardation
1.2.9 Disorders of psychological development
1.2.10 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence
1.2.11 Unspecified mental disorder
1.3 The Impact of CNS Disorders at a Global Scale
1.3.1 Disability-Adjusted Life Years and Years Lost due to Disability
1.3.2 The impact on the life of a sufferer is determined using the DALY and YLD system
1.4 Leading causes of disability-adjusted life years (DALYs), in all ages and in 15-44-year-olds, by sex, estimates for 2000
Table 1 Both Sexes, All Age Groups
Table 2 Males, All Age Groups
Table 3 Females, All Age Groups
Table 4 Both Sexes. 15 - 44 years
Table 5 Males, 15 - 44 years
Table 6 Females, 15 - 44 years
1.5 Leading causes of years of life lived with disability (YLDs), in all ages and in 15-44-year olds, by sex, estimates for 2000
Table 7 Both Sexes, All Ages
Table 8 Males, All Ages
Table 9 Females, All Ages
Table 10 Both sexes 15 - 44 years
Table 11 Males 15 - 44 years
Table 12 Females 15 - 44 years
Table 13 Leading CNS Therapies by Global Sales
Table 14 Leading CNS Therapies by Global Sales
2. Depressive Disorders
2.1 The Facts on Depressive Disorders
Graph 1 Depression - Sustained mood fluctuations
2.2 Depressive Episode - Mild, Moderate or Severe?
2.3 Major (Unipolar) Depressive Disorder
2.3.1 The symptoms of depression
2.4 Bipolar Disorder (also known as Manic Depressive Disorder)
2.4.1 The symptoms of mania
Table 15 Differentiating Clinical and Familial Characteristics of Bipolar and Unipolar Depressions
2.5 Dysthymic Disorder
2.6 The Causes of Depression
2.7 Age, Sex and Depressive Disorders
2.7.1 Depression in Women
2.7.2 Depression in Men
2.7.3 Depression in the Elderly
2.7.4 Depression in Children
3. The 'Classic' Neurotransmitters
3.1 Serotonin
3.2 Norepinephrine (noradrenaline)
3.3 Dopamine
4. Antidepressant Drug Therapies
4.1 Facts on the Antidepressive Market
Table 16 Comparative Cost of Selected Antidepressants
4.2 The Early Antidepressants
Table 17 Antidepressants : MAOIs
Table 18 Antidepressants : MAOIs
4.3 Monoamine Oxidase Inhibitors (MAOIs)
4.3.1 MAOIs and Hypertensive Crisis
4.3.2 MAOIs and Dietary Amines
4.4 Tricyclic Antidepressants
Table 19 Antidepressants : Tricyclics
Table 20 Antidepressants : Tricyclics
5. The Second Generation of Antidepressants
5.1 Selective Serotonin Re-Uptake Inhibitors
Table 21 Antidepressants : SSRIs
5.1.1 SSRIs vs TCAs
Table 22 Antidepressants : SSRIs
5.2 Why does the Medical Community Need a New Generation of Antidepressant Therapies?
6. The Newer Range of Antidepressant Therapies
6.1 Non-TCA/MAOI Atypical Antidepressants
Table 23 Antidepressants : Other Antidepressants
6.1.1 Bupropion (Wellbutrin, Amfebutamone)
6.1.2 Nefazodone (Serzone)
6.1.3 Trazodone (Desyrel, Trialodine)
6.1.4 Venlafaxine (Effexor, Effexor XR)
6.1.5 Mirtazapine (Remeron, Remeron SolTab)
7. The Future of the Market for Antidepressant Therapies
7.1 The Need for New Antidepressants - Why are More Therapeutic Compounds Required?
Table 24 % Breakdown of CNS Pipeline Products
7.2 New Antidepressants in Clinical Trials
Table 25 Number of CNS Pipeline Products
7.3 Will Current Pipelines Revolutionize the Treatment of Depression?
7.3.1 Poor treatment selection
7.3.2 Inadequate dose or duration
7.3.3 Overemphasis on symptom change
7.3.4 Inflated baseline ratings
7.3.5 High dropout rates
7.3.6 High placebo response
7.3.7 Functional unblinding
7.4 Depression Drugs on the Horizon
7.4.1 Substance P Receptor (NK1) Antagonists
7.4.2 Substance P Antagonist by Merck and Co.
7.4.3 Pregabalin by Pfizer
7.4.4 Duloxetine
7.4.5 Reboxitine (Edronax, Vestra)
7.4.6 Escitalopram (Lexapro)
7.5 Advances in Monoamine-Based Therapies
7.5.1 Postsynaptic 5-HT(1A )activity
7.6 Depression, BDNF and the cAMP Pathway
7.7 Depression, NMDA and the Glutamate System
Table 26 Antidepressants : Current and Pipeline Compounds and Products
i. TRICYCLIC ANTIDEPRESSANTS (TCA)
i.i. SELECTIVE SEROTONIN RE-UPTAKE INHIBITORS (SSRIs)
i.i.i MONOAMINE OXIDASE INHIBITORS
8. Schizophrenia/Schizotypal Disorders
8.1 What are the Symptoms of a Schizotypal Disorder?
Graph 2 Global Market for Schizophrenia Therapies
8.2 Schizophrenia: Incidence and Global Burden
8.3 The Etiology of Schizophrenia
Graph 3: Risk of Developing Schizophrenia - Familial Predisposition
8.3.1 The Dopamine Hypothesis
8.3.2 The Brain Structure Hypothesis
8.4 Diagnosis of Schizophrenia and Schizoaffective Disorders
8.4.1 Paranoid Schizophrenia
8.4.2 Hebephrenic Schizophrenia
8.4.3 Catatonic Schizophrenia
8.4.4 Undifferentiated Schizophrenia
8.4.5 Post-Schizophrenic Depression
8.4.6 Residual Schizophrenia
8.4.7 Simple Schizophrenia
9. The Treatment of Schizophrenia
9.1 Typical Neuroleptics
9.1.1 Haloperidol
9.1.2 Chlorpromazine
9.1.3 Thioridazine
9.2 The Therapeutic Benefits of "Typical" Neuroleptics
9.3 The Negative Aspects of Treatment with "Typical" Neuroleptics
9.4 "Atypical" Neuroleptics
Table 29 "Atypical"Neuroleptics
9.4.1 Amisulpride
9.4.2 Clozapine
9.4.3 Olanzapine
9.4.4 Quetiapine
9.5.5 Risperidone
9.5.6 Ziprasidone
9.5.7 Zotepine
Table 30 Relative Side-Effect Profiles of Leading Antipsychotic Drug Groups
Table 30(a) Adverse Effects Caused by Blockade of Muscarinic, Histamine
H1, and A1- Adrenergic Receptors
10. The Future of Drug Therapy for Schizophrenia and Schizoaffective Disorders
10.1 Differentiating the "Atypical"Neuroleptics
10.1.1 First Generation Neuroleptics Under the System
10.1.2 Second Generation Neuroleptics Under the System
10.1.3 Third Generation Neuroleptics Under the New System
10.2 The Future Treatment of Schizoaffective Disorders
10.2.1 Critical Interval of Antagonism
10.2.2 Specificity of D2 Receptor Affinity
10.2.3 The blockade Effect and Affinity Profile
10.2.4 Combination of Therapies for Maximum Effect
Table 31 Relative potencies of leading antipsychotic drugs
10.3 New Drugs on the Horizon for the Treatment of Schizophrenia
10.3.1 Aripiprazole
10.3.2 Iloperidone
10.3.3 DAB-452
10.3.4 MD 57445 (panamesine)
10.3.5 SR-31742
10.3.6 AD-5423 (blonanserin)
10.3.7 SC-111
Table 32 Schizophrenia : Current and Pipeline Compounds and Products
Table 33 Seizure Disorders
11. Seizure Disorders and Epilepsy
11.1 The Classification of Epilepsy
11.1.1 Symptomatic Epilepsy
11.2.2 Idiopathic Epilepsy
11.2 Types of Seizure and Disorder Manifestations
11.2.1 Partial Seizures
11.2.2 Generalized Seizures
11.2.3 Auras and Postical State
11.2.4 Simple Partial Seizures
Table 34 Specific Phenomena and Brain Area in Seizure
11.2.5 Complex Partial Seizures
11.2.6 Generalized Seizures
11.2.7 Infantile Spasms
11.2.8 Abscence Seizures
11.2.9 Generalized Tonic-Clonic Seizures
11.2.10 Atonic Seizures
11.2.11 Myoclonic Seizures
11.2.12 Febrile Seizures
11.2.13 Status Epilepticus
11.2.14 Epilepsia Partialis Continua
11.3 The Risk of Developing Epilepsy
11.4 Established Drugs for the Treatment of Epilepsy and Seizure Disorder
Table 35 Choices for Early Treatment of the More Common Types of Epilepsy
11.5 Traditional Anti-Epileptic Drug Therapies
11.5.1 Carbamazepine (Carbatrol and Tegretol)
11.5.2 Methsuximude (Celontin Kapseals)
11.5.3 Valproic Acid (Depakote, Depakene, Depacon)
11.5.4 Phenytoin (Dilantin)
11.5.5 Clobazam (Frisium)
11.5.6 Clonazepam (Klonopin)
11.5.7 Primidone (Mysoline)
11.5.8 Phenobarbital
11.5.9 Ethosuximide (Zarontin)
11.6 The Second Generation of Anti-Epileptics
11.6.1 Felbamate (Felbatol)
11.6.2 Gabapentin (Neurontin)
11.6.3 Lamotrigine (Lactimal)
11.6.4 levetiracetam (Keppra)
11.6.5 Topiramate (Topamax)
11.6.6 Tiagabine Hydrochloride
11.6.7 Oxcarbezapine (Trileptal)
11.6.8 Vigabatrin (Sabril)
11.6.9 Zonisamide (Zonegran)
12. The Future of Drug Therapy for Epilepsy and Seizure Disorders
12.1 Combined Therapy for Increased Therapeutic Benefit
12.1.1 Levetiracetam
12.1.2 Oxcarbazepine
12.1.3 Zonisamide
12.1.4 Monotherapy Using Second Generation Anti-Epileptics
12.2 New Drugs on the Horizon for the Treatment of Seizure Disorders and Epilepsy
12.2.1 SPD 421, SPD 452 and SPD 453
12.2.2 SB-204269 (Carabersat)
12.2.3 CCD-1042 (ganaxolone)
12.2.4 Retigabine
12.2.5 Pregabalin
12.2.6 TVP-1901 (Valrocemide)
12.2.7 ADD 234037 (Harkoseride)
12.2.8 Talampanel
12.3 Novel Approaches to the Treatment of Seizure Disorders
12.3.1 The Implantation of Porcine Neural Cells for the Treatment of Seizure Disorders
12.3.2 Conantokin-G (CGX-1007)
Table 36 Epilepsy : Current and Pipeline Compounds and Products
13. CNS Therapies - The Future of the Therapeutic Field
13.1 Depressive Disorders
13.2 Schizophrenia
Graph 4 Breakdown of Schizophrenia Drugs Launched by Class 1999-2005
13.3 Epilepsy
13.4 Is the Future of the CNS Market in New Developments or the Intelligent use of Existing Products?
Appendix 1
i. The Value of the Worldwide Pharmaceutical Industry
Table 37 World Drug Purchases - 12 Months to January 2002
i.i. Leading Therapeutic Categories in the Worldwide Pharmaceutical Market
Table 38 World Drug Purchases by Therapeutic Category - 12 Months to January 2002
Table 39 US Drug Purchases by Therapeutic Category- 12 Months to January 2002
Table 40 World Drug Purchases by Therapeutic Category - 12 Months to January 2002
About visiongain
Companies mentioned in CNS 2002 by visiongain
Abbott Laboratories
Akzo Nobel
Alkermes
American Home Products (Wyeth-Ayerst)
Anovis
ASTA Medical AG
AstraZeneca
Aventis
Boehringer Ingelheim
Bristol-Myers Squibb
CeNeS Ltd.
Cephalon
Cognetix
Cortex Pharmaceuticals
CoSensys
Dainippon Pharmaceuticals
Diacrin Inc.
Elan Pharmaceuticals
Eli Lilly
Fabre-Kramer Pharmaceuticals
Forest Laboratories
GSK
Innapharma
IVAX
Janssen Pharmaceutica
Janssen-Cilag
Johnson & Johnson
Kyowa Hakko
Marplan
Medtronic Inc.
Merck & Co.
Merck KgaA
Mitsubishi Chemical Corporation
Neurocrine Biosciences
Neurosearch A/S
Novartis
NPS Pharmaceuticals
Organon
Ortho-McNeil Pharmaceuticals
Otsuka America Pharmaceutical/Otsuka Pharmaceutical
Parke-Davis
Pfizer
Pharmacia
Purdue Pharma
Roche
Sandoz Pharmaceuticals
Sanofi-Synthelabo
Schwarz Pharma
Scotia Pharmaceuticals
Sepracor
Shire Pharmaceuticals
Solvay Pharmaceuticals
Somerset Pharmaceuticals
Takeda Chemical Industries
Teva Pharmaceuticals
Titan Pharmaceuticals
UCB Pharma
Viatris
Wallace Laboratories
Yamamouchi Pharmaceuticals
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