Introduction Major Depressive Disorder (MDD) is a prevalent global mental health challenge with a multifactorial etiology, including genetic, environmental, and biochemical influences. Current pharmacological treatments, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), face limitations, including delayed therapeutic onset, systemic side effects, and poor permeability across the blood-brain barrier (BBB). To overcome these challenges, intranasal NE (NE) drug delivery systems have emerged as a promising approach for enhancing drug bioavailability and facilitating direct nose-to-brain transport. Methods A comprehensive review of recent advancements in NE-based drug delivery for MDD was conducted, focusing on formulation strategies, pharmacokinetic improvements, and therapeutic outcomes. Studies evaluating the efficacy of NE formulations for delivering antidepressants, antipsychotics, and natural compounds, such as curcumin and resveratrol, were analyzed. The role of mucoadhesive agents like chitosan in enhancing nasal retention and drug absorption was also explored. Results NE formulations demonstrated superior drug delivery to the CNS, bypassing the BBB and reducing systemic toxicity. Preclinical and clinical studies indicate enhanced therapeutic efficacy, increased drug concentration at target sites, and improved patient compliance. The inclusion of mucoadhesive agents further optimized nasal retention, prolonging drug absorption and enhancing therapeutic effects. Additionally, NEs mitigated hepatic first-pass metabolism, leading to lower dosing requirements and reduced side effects. Discussion Nanoemulsion-based intranasal delivery presents a promising strategy for treating MDD, offering physiological and pharmacological advantages over oral routes. By bypassing the blood-brain barrier, these systems enable rapid and targeted brain delivery, enhancing drug efficacy. The nanoscale size improves solubility and absorption of poorly water-soluble compounds like curcumin and resveratrol. Incorporation of mucoadhesive agents such as chitosan further enhances nasal retention and drug uptake. Despite encouraging preclinical results, challenges remain in translating this approach clinically. Conclusion Intranasal NE-based drug delivery presents a transformative strategy for treating MDD and other CNS disorders. By integrating nanoscale formulation approaches with tailored pharmacokinetics, this system offers improved drug efficacy, safety, and patient adherence. Future research should focus on optimizing formulations, ensuring long-term stability, and advancing clinical translation for broader CNS applications.
Gautam et al. (Tue,) studied this question.