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NeuroPsychopharmacotherapy pp 1731–1744Cite as

History of Antipsychotics

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Abstract

Over the last 100 years, the range of therapeutic options available to psychiatry has grown significantly. A major advancement in this development was the establishment of modern psychopharmacotherapy, which started in the 1950s and led in combination with sociotherapy and psychotherapy to a significant improvement in the treatment of mentally ill patients. Modern psychopharmacotherapy created the necessary conditions for psychiatry to change from a custodial to a therapeutic discipline. This change was brought about not only by a responsible use of psychotropic drugs in the overall therapeutic context but also by a cultural and attitudinal change, i.e., a lasting change in the mentality of all actors involved in therapy, including the social destigmatization of people with mental illness. Since the treatment with psychotropic drugs has become an established method of psychiatric therapy, the ethical implications associated with their use play an increasingly important role.

However, modern pharmacotherapy has had a lasting influence on psychiatry not only in a therapeutic but also in a scientific sense. It has promoted scientific development within psychiatry, allowing for the establishment of new research fields, such as neurochemistry or psychopharmacology. Thus, the biological research approach in psychiatry regained its importance. In addition, the methodology of clinical psychiatric research was improved. Last but not least, modern pharmacotherapy changed the position of psychiatry within medicine.

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Notes

  1. 1.

    A detailed description of the discovery of chlorpromazine, including respective publications and its introduction into psychiatric practice, can be found in: Ban 2007.

  2. 2.

    Regarding the criticism of his research, especially the drug trials under ethical aspects, see: https://www.nzz.ch/schweiz/daddy-long-leg-und-seine-versuchskaninchen-ld.1509834?reduced=true. Accessed: 19 August 2020.

  3. 3.

    For the history of clozapine, see: Hippius 1999.

  4. 4.

    A chronological overview of the development of antipsychotics can be found in: Shen 1999. Shen describes the development of phenothiazines in the paint industry, the use of phenothiazines as antimalarials and narcotics, the use of chlorpromazine as an antipsychotic, as well as the development of other antipsychotics until the mid-1990s.

  5. 5.

    Regarding the use of the term “antipsychotic” and the search for terms related to antipsychotics, see: King and Voruganti 2002. The study of King and Voruganti shows the controversies which played a role in the naming and classification of drugs used in antipsychotic treatment until the early 1970s, as well as the various influences within the scientific process. The term “neuroleptic” referred to the sedative and neurological effects of the drugs in which the dopamine antagonistic mechanism of action was the main focus. In the late 1960s, the term “antipsychotic” was increasingly used (Lamb and Weinberger 2005).

  6. 6.

    In this context, it was noted that the evidence-based evaluation of the efficacy of psychotropic drugs by means of objectifying procedures relegates the subjectivity of individual experience to the background (Balz 2010). To date, the specific effects of chemical substances on thinking, feeling and perception can only be determined by the extensive involvement of affected patients. Consequently, patients’ statements, clinical exploration and the precise, preferably reproducible evidence of psychological changes are of great importance in determining what is defined as a psychopharmacological effect.

  7. 7.

    In this context there must be mentioned the outstanding achievements of Karl Leonhard (1904–1988), which include in particular the delimitation of cycloid psychoses and the differentiation between bipolar and monopolar forms of affective psychoses. Following his spiritual fathers, Carl Wernicke (1848–1905) and Karl Kleist (1879–1960), he developed a differentiated classification of endogenous psychoses, which he based on a subtle phenomenological-descriptive observation. Particularly the German work group of Beckmann in Würzburg has endeavored to achieve a biological validation of Leonhard’s diagnostic groups (cf. Beckmann et al. 2000; Ungvari 1993).

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Authors and Affiliations

  1. Institute of History of Medicine, University Medicine Rostock, Rostock, Germany

    Ekkehardt Kumbier

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  1. Ekkehardt Kumbier
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Correspondence to Ekkehardt Kumbier .

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Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Department of Psychiatry, University Hospital Leipzig, Leipzig, Germany

    Frank Schmidt

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Kumbier, E. (2022). History of Antipsychotics. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_387

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  • DOI: https://doi.org/10.1007/978-3-030-62059-2_387

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