Symptoms of mental illness arise from biological and environmental factors, including patterns of unadaptive behavior. Although many types of mental health professionals administer psychotherapy, psychiatrists, qualified as doctors, may also prescribe psychotropic medications as part of the treatment they provide.
Psychotherapy and psychotropic drugs have been shown to be effective in treating many psychiatric disorders; often, a combination of the two works best.
- The birth of modern psychopharmacology dates back to the 1950s.
- When a series of discoveries forever changed the course of psychiatry and the lives of millions of patients.
Although some are no longer commonly used, the following psychopharmaceuticals have radically changed the field of therapy, opening psychiatry to the treatment of previously considered intractable disorders. These discoveries are among the greatest achievements in the history of medicine.
The modern discovery of lithium as a treatment for bipolar disorder was made in 1948 by John Cade, an Australian psychiatrist who chose lithium because it would neutralize uric acid, which he believed was the cause of mania at the time.
As later reported, bipolar disorder has nothing to do with uric acid, which has not prevented lithium from becoming a valuable aid in the treatment of manic patients.
Lithium was the first modern psychiatric drug, as its efficacy as an antimaniac was demonstrated in 1949, prior to the discovery of chlorpromazine, then becoming the first intervention drug specific to a specific psychiatric disorder.
More than seventy years after its discovery, lithium remains the most effective drug in all psychiatry, with a response rate of more than 70% for patients with bipolar disorder, and has useful applications in the treatment of unipolar depression.
The discovery of lithium as an effective treatment for bipolar disorder marked the beginning of the psychiatric drug revolution. For the first time in history, something could be done to treat a serious mental illness.
The fortuitous discovery of lithium in 1948 was followed soon after by another miraculous discovery: the world’s first antipsychotic.
In 1949, Henri Laborit, a French military surgeon in Tunisia, was looking for a way to reduce surgical shock. While researching an antihistamine, chlorpromazine, he discovered that it had profound psychological effects on patients when administered prior to surgery.
In 1952 Laborit convinced another psychiatrist to administer this medicine to a schizophrenic patient for the first time.
The use of chlorpromazine as the first neuroleptic has swept europe, but in the United States, dominated by psychoanalysis, its reception was silenced.
At the time, American psychiatrists were looking for psychosocial explanations for schizophrenia, such as Gregory Bateson’s double bond theory. Everything about psychiatric drugs had little or no interest.
The pharmaceutical company that produced chlorpromazine (Brand Thorazine) began convincing state governments, rather than psychiatrists and medical schools, by insisting that the use of the drug could significantly reduce spending on state mental health programs.
Soon after, almost all major psychiatric hospitals in the United States had joined the chlorpromazine line. The introduction of Thorazine in the United States contributed to the deinstitutionalization movement and the number of hospitalized patients increased from about 600,000 in 1952 to 160,000 in 1977.
Chlorpromazine remains one of the most effective antipsychotic drugs, especially for patients with serious illnesses, and has useful applications in emergencies. Along with lithium, it is on the World Health Organization’s list of essential medicines.
The third historical finding of early psychopharmacology was imipramine, the first tricyclic antidepressant.
The development of the first antipsychotic (chlorpromazine) has been linked to the research of antihistamines, as in the synthesis of the first antidepressant, imipramine.
In the early 1950s, pharmaceutical companies were looking for new drugs to compete with chlorpromazine in the schizophrenia market.
Roland Kuhn, a Swiss psychiatrist hired by the pharmaceutical company Geigy, always more interested in depression than schizophrenia, has done something decisive: he decided to act without the knowledge of the pharmaceutical company that funded his research and administered this compound to him for depression. The results achieved were a revolution for the time.
Within weeks of starting imipramine treatment, Kuhn’s chronically depressed patients began to regain a sense of purpose, motivation, and hope. His depressive symptoms, previously considered intractable, responded very well to this new drug.
With the discovery of imipramine, psychiatry eventually has effective biological treatments for its three main disorders: schizophrenia, bipolar disorder and depression.
For many years, imipramine has been considered the “gold standard” for the treatment of major depression. Although its regular use has been largely replaced by new SSRIs and NSRIs, it remains useful in the treatment of atypical and refractory depressions.
Valium was invented by the chemist Leo Sternbach in Hoffman-La Roche, New Jersey (1963), being the second benzodiazepine drug discovered after Librium (Psicosedim, Brazil) in 1960.
Benzodiazepines became very popular in the 1960s and 1970s as anxiolytic, as their side effects did not have the severity of the adverse effects of barbiturates, the previous generation of sedatives.
An overdose of barbiturates can be fatal. Perhaps it is because of them that there is the cultural stereotype of “sleeping suicide. “
Benzodiazepines are only fatal in exceptional cases, as they are very safe in case of overdose, although they are highly addictive; as a family, they fall into three categories: they are sedative, anxiolytic and hypnotic, it all depends on the molecule in question. , dose and half-life in blood.
In the last 30 years, perhaps no psychiatric drug has been better known than Prozac (fluoxetine), which was discovered by Eli Lilly and Company in 1970 and entered medical use in the United States and was one of the first SSRIs.
Since the introduction of Prozac, several SSRSs have followed, each with a slightly different chemical structure and side effects profile, but similar in its basic mechanism and effectiveness. The main reason is that they cause few side effects and have a wide range of actions and side effects. Indications.
The names of SSRS are: fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram and escitalopram. The discovery of SSRS has been a historic achievement in psychiatry, and is now the most prescribed type of medication for clinical depression, anxiety disorders and obsessive-compulsive disorder. Disorder.