Remedies against Mania and Delusion (1800-1911)

1.1. Psychopharmacology at the Beginning of Modern Psychiatry

1.2. Brom and the First Synthetic Drugs

Part 2

From Bleulers Schizophrenia to Lobotomy (1911-1945)

2.1. Kraepelin and Bleuler about Drugs

2.2. Fever-Therapy

2.3. Sleep-Therapy

2.4. Insulin-Coma-Therapy

2.5. Cardiazol-Convulsive-Therapy

2.6. Electric-Convulsive-Therapy

2.7. Lobotomy

Part 3

The Triumph of Neuroleptics (1945-1965)

3.1. Before the "Revolution"

3.2. The Synthesis of Chlorpromazine

3.3. Chlorpromazine as a Psychotropic Substance

3.4. Side Effects and Chemical Strait Jacket

3.5. Neuroleptics and Creating Theories

3.6. The Introduction of "Megaphen" in Germany

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Conclusions:

1. Attempts to cure mental illness by drugs are as old as psychiatry itself.

3. Before the discovery of the neuroleptics there were somatic therapies for schizophrenia which were considered as quite successful. Most important were cardiazol-coma-therapy and electro-convulsive-therapy.

4. The discovery of the new somatic treatments was independent from research in psychopathology and aetiology. The question if the schizophrenic psychosis is acute or chronic was more important than the division into different forms.

5. A definitive appraisal of the effectiveness of psychiatric treatments is historically not possible. Only through the introduction of double-blind-studies and standardized observation of the course in the past years can we make valid and reproducible judgements. The spontaneous course of schizophrenic psychoses in an always changing environment is still a problem for the research.

6. The question of the causality of psychopharmacological treatment is often discussed. Because of the acceptance of a somehow positive effect of neuroleptics this discussion is often only academic.

7. Most of the advocates of somatic therapies point out the importance of supporting psychotherapy and social meassures. Psychoactive drugs are accepted as useful by most psychologists.

8. In neuroleptics studies there are very few references to healthy probands and the subjective feelings of patients.

9. One of the most important implications of neuroleptics on psychiatry was the use in ambulant care. This aspect which was pivotal for the acceptance of psychiatry in general medicine is very seldom mentioned in literature.

10. For no other group of drugs were side effects as important as for the neuroleptics. This concerns the risk/effectiveness relation and the research in aetiology.

11. Until the beginning of the sixties chlorpromazine was used as a drug for almost every psychiatric syndrome. The introduction of antidepressants and benzodiazepines led to the split of the indications endogenous depression and neurosis.