Psychopharmacotherapy in the Chinese population

Traditional medicine, especially herbal medicine and acupuncture, has a long history in China. Included in the voluminous classic literature of traditional Chinese medicine are specific acupuncture procedures and a large number of herbal formulas that have been regarded as useful for the treatment of mental disorders. Although most of these methods have not yet been examined with rigorous clinical trials, it does appear that, in general, they are likely to be effective in the treatment of mood disorders, but not psychotic disorders. Systematic settings to provide care for the severely mentally ill started in late nineteenth century. The first European styled mental hospital was established in Guangzhou, China, in 1898. Gradually more mental hospitals were established in other large cities in China. However, until the introduction of chlorpromazine in the 1950s, therapeutic options were extremely limited, and traditional Chinese medicine therapy, insulin coma, and electro-convulsive therapy (ECT) were commonly used for the treatment of severely disturbed patients.

As is true worldwide, the arrival of the phenothiazines in the 1950s heralded a new era for the treatment of psychotic disorders in China. The earliest antipsychotic medications used included rauwolfiae, reserpine, promazine, and acetylpromazine. In 1956, domestic chlorpromazine was produced in Shanghai. Based on open clinical trials and descriptive clinical case observations, the clinical profiles of these potent agents, including their efficacy and tolerability, were established in the Chinese populations.