In spite of tremendous development in central nervous system research, current 
treatment is suboptimal, especially in severe mental disorders. In medicine, 
there are two main methods of improving the health care provided: seeking new 
treatment procedures and perfecting (optimizing) the existing ones. Optimization 
of treatment includes not only practical tools such as therapeutic drug 
monitoring but also implementation of general trends in the clinical practice. 
New pharmacological options include new more sophisticated forms of 
monoaminergic drugs, old drugs rediscovered on the base of a better 
understanding of pathophysiology of mental illnesses, and drugs aimed at new 
treatment targets. In depression, treatment resistance to antidepressive 
pharmacotherapy represents one of the most important clinical challenges. 
Switching to monotherapy with new multimodal/multifunctional antidepressants and 
augmentation with new atypical antipsychotics (aripiprazole and brexpiprazole) 
may be promising options. Further, current evidence supports utility and safety 
of adjunctive treatment of nutraceuticals. Novel approaches being studied 
include ketamine and opioids. Recent advances in technology and emerging 
knowledge about dysfunctional brain circuits and neuroplasticity have led to the 
development of different new neuromodulation techniques usually used as add-on 
therapy. Antipsychotics are still the cornerstone of the current treatment of 
schizophrenia. Two new partial dopamine agonists, brexpiprazole and cariprazine, 
are now available in addition to aripiprazole. Although the mechanisms of action 
are similar, the two agents differ in terms of their pharmacodynamic profiles. 
Further, two new formulations of long-acting injections of second-generation 
antipsychotics (aripiprazole lauroxil and 3-month paliperidone palmitate) were 
introduced into clinical practice. New treatment options not yet available 
include cannabidiol, glutamate modulators, and nicotine receptors agonists.