ACNP Research Highlights With Thomas R. Kosten, MD

Thomas R. Kosten, MD

Promising advances are being discussed at the 63rd Annual Meeting of the American College of Neuropsychopharmacology in Phoenix, Arizona.

Kosten, a member of the Psychiatric Times editorial board, shared his thoughts on the meeting itself as well as the presentations for promising new targets. Although still early in the meeting, he has already attended several presentations, including the Promising Targets Oral Session. Thus far, Kosten said the meeting has been informative, giving clinicians and researchers alike the opportunity to look forward and consider new approaches in psychiatry.

Specifically, Kosten was intrigued by a session discussing advances inspired by rapid-acting NMDA antagonists like ketamine. Emerging treatments promise similar rapid efficacy without ketamine’s hallucinogenic side effects, he said. Unlike ketamine’s effects, which last a few hours, Kosten noted these medications showed sustained benefits over several days, marking a significant step forward. Plus, he spoke of the benefit of oral administration. He eagerly anticipates the upcoming placebo-controlled phase 2 and phase 3 trials, warning that the results may not seem as positive in such trials.

Phosphodiesterase inhibitors, once considered too non-specific to be viable, is also receiving renewed attention, Kosten said. This may help unlock their use in schizophrenia and other conditions.

Another exciting development involved a nicotinic cholinergic agonist, Kosten reported, which demonstrated remarkable efficacy in treating PTSD. “PTSD is not overwhelmingly well treated by our existing couple of agents,” he commented.

In reflecting on pharmacological advances, Kosten said there have been both successes and limitations of recent developments. Although the cholinergic modulator emraclidine faces challenges, there have been some breakthroughs. Cobenfy, a novel treatment for schizophrenia, was heralded as a “real success story” after overcoming early side effect issues through innovative modifications. “This is a major advance we’ve been waiting for since at least 25 years,” he said, referring to the failed first attempt of working with the agent due to its adverse events.

Kosten said the ACNP Annual Meeting and presentations like these reflect a dynamic and hopeful era in neuropsychopharmacology. He commended the ACNP for its its commitment to translational research as well as diversity efforts, noting the meeting has changed for the better over time, becoming more inclusive and sharing a variety of voices and perspectives.

Kosten is the JH Waggoner Chair and Professor of Psychiatry, Pharmacology, Immunology, and Neuroscience; Director, Section of Alcohol & Addiction Psychiatry, Baylor College of Medicine, Houston, Texas.

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