Disorders of the brain and CNS are a leading cause of disability, accounting for more hospitalizations and long-term care than all other diseases combined (182). As discussed previously in this chapter, transport across the BBB is the major obstacle to effective drug delivery to the brain. Accordingly, the BBB is regarded as the bottleneck in development of neurotherapeutics (124). Extensive research over the years has identified various strategies to enhance brain uptake of medications. These approaches were detailed in the previous section, and a number of examples were provided.
Formulation scientists have successfully devised new drug formulations and delivery systems to improve therapeutic outcomes for patients suffering with brain and CNS disorders (Table 3). As our understanding of the physiology of the brain continues to increase, new strategies are being investigated to enhance drug delivery to the brain. A summary of recent developments in drug therapy for specific CNS disorders is provided below. For certain diseases (e.g., ADHD, depression), the impact of novel formulations on therapeutic outcomes are discussed. For those conditions that are largely refractory to drug therapy (HIV, brain tumors), strategies that are proposed to address therapeutic shortcomings associated with these diseases.
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