Dennis S. Charney, MD, Discusses the Last 40 Years in Psychiatry and Shares his Hopes for the Future

Celebrating Psychiatric Times 40^th anniversary, Dennis S. Charney, MD, dean of the Icahn School of Medicine at Mount Sinai for the past 18 years, spoke about the history of psychiatry and where he hopes the future lies.

"The most important advances [include] better treatment for psychiatric patients," said Charney. "We've had some advances in the treatment of schizophrenia. Recently, there's been a new drug that has been approved by the FDA that has a different mechanism than the traditional antipsychotic drugs, which have focused on blocking the effect of dopamine. The newer drug works through the cholinergic system."

In the field of depression treatment, Charney points to Spravato, a major breakthrough for which he is a coinventor. The rapid-acting antidepressant is for treatment-resistant depression and has a different mechanism than the traditional antidepressants that work on the monoamines, he said.

He also discussed ongoing research into psychedelic drugs. "There's been a lot of work on psychedelic drugs in terms of their mechanism and whether or not they will be effective treatments for depression and post-traumatic stress disorder,” Charney said, adding that work still needs to be done in that field. “ No drug has yet been approved by the FDA, but a lot of work [is being done] on improving psychotherapies of all different types that have been helpful to patients," he said.

Genetics, Charney thinks, is another area of progress. There has been a lot of work to develop a better understanding of the genetics of psychiatric disorders. "A number of different genes and gene variations have been discovered that relate to schizophrenia and depression, among other conditions. A lot of promise there going forward."

Brain imaging has also contributed to psychiatric research, with other discoveries being made around the circuitry involved in major psychiatric disorders using brain imaging.

Despite these advancements, Charney acknowledged that challenges remain. "We still need better treatments. The effect of psychiatric disorders on the health and welfare of populations around the world is still extraordinarily high."

Looking ahead, he emphasizes the need for continued progress, saying, "We need to improve our diagnostic system, which is primarily related to symptom profiles and not pathophysiology. That needs to improve over the next 40 years. And, of course, we need to develop better ways of enhancing resilience in our patients, developing better ways of preventing serious forms of mental illness."

This is part 1 of a multipart video series. Visit psychiatrictimes.com to view the rest as they are posted.

Dr Charney is the dean of the Icahn School of Medicine at Mount Sinai. He is the author of Neurobiology of Mental Illness, The Physician’s Guide to Depression and Bipolar Disorders, and Molecular Biology for the Clinician. He is a professor of psychiatry, neuroscience, and pharmacology and systems therapeutics at Icahn School of Medicine at Mount Sinai.