Although options for pharmacologic treatment for depression have grown seemingly exponentiallyover the past several decades, the current armamentarium of antidepressants continues to havelimitations of both efficacy and tolerability. The problems include an unacceptable lack of efficacy,delayed onset of therapeutic effects, an inability to predict responses to one or another agent, drug-druginteractions, and difficulty with tolerability during both acute and chronic treatment. This articlereviews the problems that persist in the use of currently available antidepressant medications and presentsa list of attributes that would be characteristic of the ideal antidepressant.
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