Steve Davis, CEO of ACADIA Pharmaceuticals
Life’s important moments are defined by connecting with loved ones – treasuring a warm hug or a hearty laugh. Priceless moments, particularly if you’ve experienced the pain and uncertainty of seeing one’s sense of self slip away due to a mental illness.
The Covid-19 pandemic and its impact on mental health is helping people empathize with how it feels to lose a piece of oneself to factors outside of anyone’s control. At the height of the pandemic, a Kaiser Family Foundation poll reported nearly half of Americans feel that Covid-19 is harming their mental health, and a federal emergency hotline for people in emotional distress registered a more than 1,000 percent increase in April alone. The challenges of our current reality are why ACADIA works tirelessly for those who need us most – the patients, families and physicians who deserve vital solutions for mental health conditions.
Breaking through – the science to find new treatment pathways
Developing treatments for central nervous system (CNS) disorders is notoriously challenging. Clinical trials carry high failure rates, a reality that contributed to cuts in research funding by more than 70 percent in the last decade. Slow progress and the lack of effective treatments creates frustration among physicians who, many times, deliver devastating news to patients without the ability to alleviate their suffering.
In the 1990s, ACADIA set out to change the paradigm. Our research led to the development of a selective serotonin inverse agonist (SSIA) that targets 5-HT2A serotonin receptors in the brain. Diseases such as Parkinson’s and Alzheimer’s alter serotonin signaling and may result in psychotic symptoms, like hallucinations and delusions. The selective binding and blocking of 5-HT2A receptors plays a critical role in the management of psychotic symptoms without impacting motor function.
This breakthrough discovery led to our first FDA approval of a SSIA in 2016 for the hallucinations and delusions associated with Parkinson’s disease psychosis. Today, our research has led to a deeper understanding of the 5-HT2A receptor and its role in psychosis and depression. ACADIA’s late-stage pipeline has three programs leveraging the possibilities of our SSIA, including a potential new approval in dementia-related psychosis.
But we aren’t stopping there. We initiated early clinical research this year with Vanderbilt University targeting the positive allosteric modulators of the muscarinic M1 receptor in the brain. By increasing sensitivity to a neurotransmitter known as acetylcholine, this may represent a novel approach for improving cognitive function and other neuropsychiatric symptoms in patients with CNS disorders.
Breaking through – the misunderstanding of disease
We cannot treat the whole person if we do not fully understand their disease. Parkinson’s disease and dementia are two illnesses that typically strike later in life and carry a high disease burden, as well as symptoms that are widely misunderstood.
Parkinson’s disease is categorized as a movement disorder. Treatment focuses on the motor symptoms, but approximately 50 percent of Parkinson’s patients may develop hallucinations and delusions during their illness. Similarly, 30 percent of people with dementia may also develop these symptoms. The impact of neuropsychiatric symptoms that develop in these progressive diseases are profound.
When a loved one is believing things that aren’t true or seeing things that aren’t real, the loss of connection to that person is devastating. Often patients and caregivers may not realize that these symptoms of psychosis are related to their disease. As a result, they may be afraid to bring up these symptoms with their physicians. In the case of Parkinson’s, fewer than one in five will.
Helping patients with hallucinations and delusions means championing the person beyond their disease. At ACADIA, this means developing effective treatments but also educating families and physicians about the neuropsychiatric symptoms of diseases and supporting policies that improve diagnosis and management. Our goal is to help reduce fear and uncertainty, and restore moments where families can be with the person they know versus the person they are losing to the disease.
Breaking through – the stigma in mental health
In the U.S., nearly 60 percent of people with mental illness don’t receive treatment. Unfortunately, negative stereotypes are common and as a result people don’t seek help or fully discuss their symptoms. This considerable stigma can lead to a delayed diagnosis or ineffective treatment.
Mental illness is not a reflection of the person, and treatment needs to be highly individualized. What works for one person may not work for another. This is particularly true in major depressive disorder (MDD). Of the 17 million Americans with MDD, the majority do not adequately respond to initial antidepressant therapy so more medications are added that may have unwanted side effects such as weight gain, further contributing to the stigma.
Schizophrenia is a severe mental illness characterized by disturbances in cognition and positive and negative symptoms. Positive symptoms may include hallucinations or delusions, and are more apparent than negative symptoms such as social and emotional withdrawal, which are “missing” and harder to diagnose, and add to the stigma associated with the illness. Negative symptoms carry a substantial burden for patients and caregivers, leading to limited functioning or disability, poor interpersonal relations and considerably higher rates of hospitalization. Approximately 40-50 percent of schizophrenia patients experience predominant negative symptoms (NSS) and today there is no FDA-approved treatment.
There’s no place for stigma in health care. Treating the symptoms at the expense of the person is not enough. We can do better, and that’s why we are doubling down on researching a potential treatment for MDD and NSS.
Breaking through – for you
Many of us at ACADIA have first-hand experience with loved ones impacted by mental health challenges. We are connected by a shared passion to break through these challenges and fight for the lives of the people we serve.
For those of you fighting for yourself or fighting for someone you love, we are by your side. ACADIA is committed to fulfilling the promise of science to elevate life. Elevating the person above their disease rather than allowing the disease to define the individual is what drives us. We want to enable brighter moments for you and those whom you love. What’s that moment for me? Seeing my loved one shine through with a smile.