Table of Contents
Executive Summary
- Current market landscape & dynamics
- Major depressive disorder
- Anxiety disorders
- Schizophrenia
- Sleep disorders
- Alzheimer' s disease and other dementias
- Movement disorders
- Epilepsy
- Pain
- Pipeline analysis: paradigm shift and incremental innovation
Chapter 1 Current market landscape & dynamics
- Summary
- Introduction
- Patient potential
- The current CNS market
- CNS sales by disease and top 5 brands per disease category
- CNS sales by drug class
- CNS sales by country
- Top CNS companies
- Top CNS brands
- Unmet needs
- Psychiatric disorders
- Depression
- Anxiety
- Schizophrenia
- Sleep disorders
- Neurologic disorders
- Alzheimer' s
- Epilepsy
- Movement disorders
- Pain
- Innovations in CNS
Chapter 2 Major depressive disorder
- Summary
- Introduction
- Epidemiology and economic burden
- Current drug treatments
- Limitations
- Key unmet needs
- Novel treatments for major depressive disorder
- Directly acting serotonergic receptor agonists
- Specific noradrenaline reuptake inhibitors (NARI)
- Serotonin/noradrenaline reuptake inhibitors (SSNRI) and mixed, multiple
- reuptake inhibitors (MMRI)
- Multi-target strategies
- Neuropeptides and stress
- Neurokinins
- CRF-1
- Others
- Future directions
- Conclusions
Chapter 3 Anxiety disorders
- Summary
- Introduction
- Epidemiology and economic burden
- Current drug treatments
- Limitations
- Key unmet needs
- Novel treatments for anxiety disorders
- GABA-A positive modulators
- 5-HT1A receptor agonists
- ƒÀ-3-adrenoceptor agonists
- NK-1 and CRF-1 receptor antagonists
- AVP V1b antagonists
- Cholecystokinin-2 (CCK-2) receptor antagonists
- Fatty acid amide hydrolase (FAAH) inhibitors
- Metabotropic glutamate 3 (mGlu3) receptor agonists and mGlu5 receptor
- antagonists
- Vomeropherins
- Future directions
- Conclusions
Chapter 4 Schizophrenia
- Summary
- Introduction
- Epidemiology and economic burden
- Current drug treatments
- Limitations
- Key unmet needs
- Novel treatments for schizophrenia
- Monoaminergic systems
- Dopamine
- 5-HT2A receptor antagonists and inverse agonists
- Combined monoamine receptor antagonists
- Non-monoaminergic strategies
- Glutamate
- Cholinergics
- Neuropeptides
- Future directions
- Conclusions
Chapter 5 Sleep disorders
- Summary
- Introduction
- Epidemiology and economic burden
- Current drug treatments
- Limitations
- Key unmet needs
- Novel treatments for sleep disorders
- GABA-ergic treatments
- Serotonergic treatments
- Others
- Future directions
- Conclusions
Chapter 6 Alzheimer' s disease & other dementias
- Summary
- Introduction
- Epidemiology and economic burden
- Current drug treatments
- Acetylcholinesterase inhibitors
- NMDA antagonists
- Limitations
- Key unmet needs
- Novel treatments for Alzheimer' s disease
- Symptomatic treatments
- Cholinergic mechanisms
- Glutamatergic mechanisms
- Serotonergic mechanisms
- Other mechanisms
- Disease process modifiers
- Amyloid cascade based treatments
- Neuroinflammatory approaches
- Neurotrophic factor approaches
- Future directions
- Conclusions
Chapter 7 Movement disorders
- Summary
- Introduction
- Parkinson' s disease
- Epidemiology and economic burden
- Current drug treatments
- Limitations
- Key unmet needs
- Novel treatments for Parkinson' s disease
- Adenosine A2A receptor antagonists
- Stem cell and gene therapy for the dopaminergic system
- Disease modifying strategies for PD
- Glutamatergic strategies
- Motor neuron disease/amyolateral sclerosis
- Epidemiology and economic burden
- Current drug treatments
- Novel treatments for motor neuron disease/amyolateral sclerosis
- Drug discovery approaches
- Future directions
- Huntington' s disease
- Epidemiology and economic burden
- Current drug treatments
- Novel treatments for Huntington' s disease
- Future directions
- Conclusions
Chapter 8 Epilepsy
- Summary
- Introduction
- Epidemiology and economic burden
- Current drug treatments
- Limitations
- Key unmet needs
- Novel treatments for epilepsy
- GABA-ergic treatments
- Ion channels
- Glutamate
- AMPA antagonists
- NS1209
- E2007
- Talampanel/LY300164
- Junction gap blockers
- Future directions
- Conclusions
Chapter 9 Pain
- Summary
- Introduction
- Epidemiology and economic burden
- Current drug treatments
- Limitations
- Key unmet needs
- Novel treatments for pain disorders
- Pain
- NMDA receptor antagonists
- Cannabinoids
- Calcium channel modulators
- Nicotinic receptor agonists
- Mu opiate receptor agonists
- Delta opiates
- Migraine
- Triptans and NSAIDs
- Non-serotonergic treatments
- Calcitonin Gene Related Peptide (CGRP)
- Gap junction blockers
- Vanilloids
- Ion channel blockers
- Other novel mechanisms
- Conclusions
Chapter 10 Pipeline analysis: paradigm shift and incremental innovation
- Summary
- Introduction
- Risk and innovation: not a straight choice
- Sanofi-Aventis
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Merck & Co.
- Building on the value of the pipeline
- Conclusions
- Limited impact of the genomics revolution
- The problem of diagnosis
- Away from the blockbuster model: smaller markets, smaller indications,
and the place of smaller companies
Chapter 11 Appendix
List of Figures
- Figure 1.1: Evaluation of current treatment options for CNS indications
- Figure 2.2: Competitive dynamics of drug classes and leading brands in the
depression market, 2005
- Figure 4.3: Competitive dynamics of drug classes and leading brands in the
schizophrenia market, 2005
- Figure 6.4: Competitive dynamics of drug classes and leading brands in the
Alzheimer' s disease market, 2005
- Figure 7.5: Competitive dynamics of leading brands in the Parkinson' s
disease market, 2005
- Figure 8.6: Competitive dynamics of drug classes and leading brands in the
epilepsy market,
List of Tables
- Table 1.1: Prevalence of CNS disorders in the 7 major markets (US, Japan,
France, Germany, Italy, Spain, UK), 2005
- Table 1.2: Global CNS market dales by disease category, 2004-05
- Table 1.3: Top 5 brands in each disease category, 2005
- Table 1.4: Global CNS market sales by drug class, 2004-05
- Table 1.5: CNS drug sales by country, 2005
- Table 1.6: Top 20 companies in the CNS market by sales, 2005
- Table 1.7: Top 20 global CNS brands, 2005
- Table 1.8: Medicinal chemical properties of a successful CNS drug
- Table 2.9: Present development status of potential antidepressants, 2006
- Table 3.10: Present development status of potential anxiolytics - Phase II
and III, 2006
- Table 3.11: Present development status of potential anxiolytics - Phase I
and Preclinical, 2006
- Table 4.12: Present development status of potential antipsychotics, 2006
- Table 5.13: Drugs currently in use for the treatment of insomnia, 2006
- Table 5.14: Present development status of potential hypnotics, 2006
- Table 6.15: Present development status of potential symptomatic treatments
for Alzheimer' s disease, 2006
- Table 6.16: Present development status of potential disease modifying
treatments for Alzheimer' s disease, 2006
- Table 7.17: Present development status of potential treatments for
Parkinson' s disease, 2006
- Table 7.18: Present development status of potential treatments for motor
neuron disease/ALS, 2006
- Table 7.19: Present development status of potential treatments for
Huntington' s disease, 2006
- Table 8.20: Present development status of potential novel anti-epileptic
drugs, 2006
- Table 9.21: Side effects limiting the pharmacological treatment of pain
with present pharmaceuticals
- Table 9.22: Present development status of potential treatments for pain
disorders, 2006
- Table 9.23: Present development status of potential treatments for
migraine disorders, 2006
- Table 10.24: Sanofi-Aventis' CNS pipeline, 2006
- Table 10.25: Pfizer' s CNS pipeline, 2006
- Table 10.26: AstraZeneca' s CNS pipeline, 2006
- Table 10.27: GlaxoSmithKline CNS pipeline, 2006
- Table 10.28: Merck & Co.' s CNS pipeline, 2006
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