Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-12-02T23:37:58.289Z Has data issue: false hasContentIssue false

Happy birthday neuroleptics! 50 years later: la folie du doute

Published online by Cambridge University Press:  16 April 2020

Emmanuel Stip*
Affiliation:
Université de Montréal, hôpital Louis-H. Lafontaine, Montreal, Canada
*
*Correspondence and reprints: Centre de recherche Fernand-Seguin, 7331, rue Hochelaga, Montréal, (Qc), H1N 3V2, Canada. Fax: +514-251-2617. E-mail address: emmanuel.stip@umontreal.ca (E. Stip).

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Given that we are celebrating the 50th birthday of neuroleptics introduction in psychiatry, the author proposes to take a look at certain results related to therapeutic practice. After a brief chronological literature review of the clinical practices and theoretical models that have controlled drug treatment of schizophrenia, the author presents a critical review of four meta-analyses. Since Delay, Deniker and Harl’s initial report, the story of neuroleptics comprises several periods. In 1963, the hyper-dopaminergic theory of psychoses was proposed. Another period began with models mainly based on the serotonin/dopamine relative blockade receptor hypothesis. More recently, a new framework to understand the differential effect of antipsychotics is related to the appropriate modulation (e.g., fast dissociation) of the D2 receptor alone. The concept of atypicality has become a new vista for research and to market new compounds. However, after 50 years of neuroleptic drugs, are we able to answer the following simple questions: Are neuroleptics effective in treating schizophrenia? Is there a difference between atypical and conventional neuroleptics? How do the efficacy and safety of newer antipsychotic drugs compare with those of clozapine? Actually, the answers yielded by these simple questions by meta-analysis should elicit in us a good deal of humility. If we wish to base psychiatry on evidence-based medicine, we run a genuine risk in taking a closer look at what has long been considered fact. Each psychiatrist must continue to be critical, sceptical, optimistic (not overoptimistic) and to learn in order to integrate the positive aspects of our growing knowledge base.

Type
Editorial
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS. 2002

References

Abely, PAbdouchelli, AFourment, JSchmitz, BDelteil, PSuite aux essais de rééquilibration instinctivo-affective: essai de traitement par le B.T.E.A. en comparaison avec le 4560 RP et C.9295. Ann. Med-Psychol. 1952;110(2):262–7.Google Scholar
Arnold, OHHift, SSolms, WUber die anwendung eines zentral vegetativen Himmungs-stoffes in der psychiatrischen Therapie. Wiener Med. Wochenschr. 1952;102:965–9.Google Scholar
Azouri, ETraitement des états d’excitation et d’agitation par une phénothiazine d’action centrale élective. Jées Méd de Beyrouth. Expans. Scient. 1952;2:293–5.Google Scholar
Carlsson, ALindqvist, MEffect of chlorpromazine or haloperi-dol on formation of 3-methoxytyramine and norepinephrine in mouse brain. Psychiatr. Acta Pharmacol. 1963;20:140–4.CrossRefGoogle ScholarPubMed
Chakos, MLieberman, JHoffman, EBradford, DSheitman, BEffectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: A review and meta-analysis of randomised trials. Am. J. Psychiatr. 2001;158: 518–26.CrossRefGoogle Scholar
Chertok, L[30 years later. The story of the discovery of neuro-leptics]. Ann. Med-Psychol. (Paris) 1982;140(9):971–6.Google Scholar
Delay, JDeniker, P38 cas de psychoses traitées par la cure prolongée et continue de 4560 RP. C.R. 50e Congrès des aliénistes et neurol. de Langue Fse 1952:503–13.Google Scholar
Delay, JDeniker, P(le 4560 RP utilisé seul en cure prolongée et continue)Le traitement des psychoses par une méthode neuro-lytique dérivée de l’hibernothérapie. C.R. 50e Congrès des aliénistes et neurol. de Langue Fse 1952:495–502.Google Scholar
Delay, JDeniker, PRéactions biologiques observées au cours du traitement par le Chlorte de diméthylaminopropyl-N-chlorophénothiazine. C.R. 50e Cong. des aliénistes et neurol. Langue Fse 1952:514–8.Google Scholar
Delay, JDeniker, PHarl, JMTraitement des états d’excitation et d’agitation par une méthode médicamenteuse dérivée de l’hibernothérapie. Ann. Med-Psychol. 1952;110(2):267–73.Google Scholar
Delay, JDeniker, PHarl, JMUtilisation en thérapeutique psychiatrique d’une phénothiazine d’action centrale élective. Ann. Med-Psychol. 1952;110(2):112–7.Google Scholar
Delay, JDeniker, PHarl, JMGrasset, ATraitement d’états confusionnels par le Chlorte de diméthylaminopropyl-N-chloro-phénothiazine (4560 RP). Ann. Med-Psychol. 1952; 110(2):398–403.Google Scholar
Deniker, P(brief history of the neuroleptics)From chlorprom-azine to tardive dyskinesia. Psychiatr. J. Univ. Ott. 1989;14(1): 253–9.Google ScholarPubMed
Deniker, P[30 years of neuroleptic chemotherapy in psychiatry (evolution of the concept and practice)]. Bull. Acad. Natl. Med. 1982;166(1):113–21.Google Scholar
Deniker, PImpact of neuroleptic chemotherapies on schizophrenic psychoses. Am. J. Psychiatr. 1978;135(8):923–7.Google ScholarPubMed
Deniker, PQui a inventé les neuroleptiques? Confront. Psychi-atr. 1975;13:7–17.Google Scholar
Deschamps, AHibernation artificielle en psychiatrie. Presse Méd. 1952;60:944–5.Google Scholar
Deschamps, ALes ganglioplégiques en thérapeutique psychiatrique. Sem. Méd. 1952:650–3.Google Scholar
Ey, HBerard, ELes nouvelles techniques de cures de sommeil dans la pratique psychiatrique. Evol. Psychiatr. 1952;4:661–82.Google Scholar
Geddes, JFreemantle, NHarrison, PBeddington, PAtypical antipsychotics in the treatment of schizophrenia: Systematic overview and meta-regression analysis. Br. Med. J. 2000;321: 1371–6.CrossRefGoogle ScholarPubMed
Golse, JLe traitement du délire aigu par l’hypernation. Ann. Med-Psychol. 1952;110(2):731–4.Google Scholar
Hamon, JParaire, JValluz, JRemarques sur l’action du 4560 RP sur l’agitation maniaque. Ann. Med-Psychol. 1952;110: 331–5.Google Scholar
Kapur, SRemington, GAtypical antipsychotics. Br. Med. J. 2000;321(7273):1360–1.Google ScholarPubMed
Kapur, SSeeman, PDoes fast dissociation from the dopamine d(2) receptor explain the action of atypical antipsychotics? A new hypothesis. Am. J. Psychiatr. 2001 Mar;158(3):360–9.CrossRefGoogle ScholarPubMed
Wadenberg, MLSoliman, AVanderSpek, SCKapur, SDopamine d(2) receptor occupancy is a common mechanism underlying animal models of antipsychotics and their clinical effects. Neuropsychopharmacology 2001;25(5):633–44.CrossRefGoogle ScholarPubMed
Laborit, HHuguenard, PAlluaume, RUn nouveau stabilisateur végétatif (le 4560 RP. Presse Med. 1952;60:206–8.Google Scholar
Leucht, SPitschel-Walz, , Abraham, DKissling, WEfficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials. Schizophr. Res. 1999;35:51–68.Google ScholarPubMed
Lehmann, HEBan, TAThe history of the psychopharmacology of schizophrenia. Can. J. Psychiatr. 1997 Mar;42(2):152–6.CrossRefGoogle ScholarPubMed
Loo, HBrochier, TPoirier, MFOlie, JP[40 years of neuroleptic drugs]. Ann. Med-Psychol. (Paris) 1993;151(3):271–6.Google Scholar
Meltzer, HYClinical studies on the mechanism of action of clozapine: the dopamine-serotonin hypothesis of schizophrenia. Psychopharmacology (Berlin) 1989;99(Suppl):S18–27.CrossRefGoogle ScholarPubMed
Meltzer, HYBiological studies in schizophrenia. Schizophr. Bull. 1987;13(1):77–111.CrossRefGoogle Scholar
Pocidalo, JJCathala, HPHimbert, JTardieu, MmeAction sur l’excitabilité sympathique du 4560 RP. C.R. Soc. Biol. 1952; 146:368–70.Google Scholar
Stip, ENovel antipsychotics: issues and controversies. Typicality of atypical antipsychotics. J. Psychiatr. Neurosci. 2000;25: 137–53.Google ScholarPubMed
Stip, ELiddle, PSoucy, JPNeed for a new framework to understand the mechanism of all antipsychotics. J. Clin. Psychiatr. 2000;61(5):387–8.CrossRefGoogle ScholarPubMed
Thornley, BAdams, CContent and quality of 2000 controlled trials in schizophrenia over 50 years. Br. Med. J. 1998;317: 1181–4.CrossRefGoogle ScholarPubMed
Tuunainen, AWahlbeck, KGilbody, SMNewer atypical antipsychotic medication versus clozapine for schizophrenia. Cochrane database Syst. Rev. 2000(3).Google Scholar
Submit a response

Comments

No Comments have been published for this article.