Market surveys on women, men and depression suggest an estimated 4.4 million Americans are believed to suffer from chronic treatment-resistant depression. Depression is a chronic, disabling disorder and a major worldwide public health problem. Depressive episodes usually recur over time, with risk for further episodes proportional to the number of prior episodes. After three major depressive episodes, the probability of recurrence is 90%. In the U.S. alone, approximately 18 million people suffer from depression over six million of which are receiving some form of medical treatment.



Market studies on women, men and depression also estimate that over 100,000 Americans each year are treated with electro convulsive therapy (ECT) for their depression. Roughly 15% of all people with severe depression that require hospitalization commit suicide. Disorders related to men and depression are also very expensive. Depression is ranked as the second leading cause of disability worldwide in 1990. Depression costs in the U.S. alone are estimated to exceed $50 billion annually, including over $12 billion in direct treatment costs. The total market in the U.S. for anti-depressants is estimated to exceed $6 billion.

Several general factors may be linked to women, men and depression but the exact causes of depressive disorders are unknown, although both biological abnormalities and psychological factors are thought to precipitate this disease. Diminished synaptic concentrations of neurotransmitters, especially serotonin and norepinephrine, are implicated in the pathogenesis of depression. Most current standard therapies regarding men and depression are thought to affect either one or both of these neurotransmitter systems (1) SSRI drugs (serotonin-specific reuptake inhibitors) or (2) MAOI drugs (monoamine oxidase inhibitors) that decrease the breakdown of norepinephrine and serotonin. It is of interest to note that several antiepileptic compounds, such as carbamazepine, valproate and lamotrigine, are used as mood stabilizers and that lamotrigine and gabapentin are also used as antidepressants.