PSYCHOPHARMACOLOGY
USE OF MEDICATION IN PSYCHIATRIC ILLNESSMedications for the treatment of psychiatric illnesses are a relatively recent development in effective psychiatric care. For many years biological therapies such as diet or hydrotherapy were utilized. In 1938 electroconvulsive therapy came into use as a therapeutic intervention and later, insulin shock therapy. The earliest phase of psychopharmacological intervention began about 55 years ago when barbiturates and amphetamines were synthesized. In 1949, John Cade, an Australian physician, noted that lithium work to subdue wild behavior in animals. Another decade elapsed before use of lithium became an accepted psychopharmacological intervention for manic=depressive illnesses. Other psychotherapeutic agents came into use in indirect was as well. Chlorpromazine (Thorazine) which is now regarded as the original major tranquilizer was developed as an antihistamine. When its effects on thought patterns behavior, affect and perceptions were noted, it was introduced as a tranquilizer to treat schizophrenia. First used as an antipsychotic medication in 1952, Thorazine became widely used to treat schizophrenia by the mid 1950’s. The push to develop better antipsychotic medications lead to the discovery of the tricyclic antidepressive agents. Another type of anti-depressant drugs, the MAO (mono amine oxidase) inhibitors was accidentally discovered also. These drugs were used in the treatment of TB and researchers noted the improved mood and affect in TB patients taking MAAO inhibitors.
The development and se of psychopharmacological agents has resulted in a veritable revolution in the treatment of psychiatric disorders. Emphasis in psychiatric research and treatment has evolved to a focus today which is strongly biological and the effective use of medications which act primarily on the neurochemistry of the brain can be viewed as one of the driving forces in this evolution. While the majority of psychiatrists utilize various forms of psychotherapeutic interventions, expertise in psychopharmacology is an essential skill in modern effective psychiatric care. Before discussing the various classes of drugs, their uses and side effects, here are some principles which underlie effective psychopharmacological intervention.