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Neuroleptics: Clinical Use in Psychiatry

  • Chapter
Handbook of Psychopharmacology

Abstract

A revolution in modern clinical psychopharmacology began with the almost simultaneous discovery of two chemically very different drugs that were able to alter psychotic behavior of hospitalized psychiatric patients (Shepherd el al., 1968). Reserpine, which has ultimately proven to be the less important of the two drugs, had been observed to have antianxiety effects in hypertensive patients and taming effects in the rhesus monkey. It had also been known for some time that the source of reserpine, the Rauwolfia serpentina root, was used in Hindu native medicine for centuries as a treatment for insanity. Its initial trial on disturbed psychotics in 1952 was well controlled and showed that the active drug caused a statistically significant decrease in hours spent in restraint or seclusion as compared to placebo treatment (Klein, 1954). It would appear that the major defect in the design, in retrospect, was the failure of the investigators to establish the effective dose of reserpine before beginning the trial. At the dose used (1 mg/day) the drug’s effect might have been missed had not relatively larger numbers of patients been employed in the experiment. The discovery of the efficacy of reserpine was, therefore, the outcome of a relatively methodical procedure of scientific investigation. However, reserpine proved to be slower acting and less effective than chlorpromazine, a drug which was to revolutionize clinical psychopharmacology over the following decade.

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Authors and Affiliations

  1. Departments of Research, Illinois State Psychiatric Institute, Chicago, Illinois, 60612, USA

    John M. Davis & David L. Garver

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  1. John M. Davis
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Editors and Affiliations

  1. Department of Pharmacology, University of Cambridge, USA

    Leslie L. Iversen

  2. Department of Psychology, University of Cambridge, USA

    Susan D. Iversen

  3. Departments of Pharmacology and Psychiatry, The Johns Hopkins University School of Medicine, USA

    Solomon H. Snyder

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Davis, J.M., Garver, D.L. (1978). Neuroleptics: Clinical Use in Psychiatry. In: Iversen, L.L., Iversen, S.D., Snyder, S.H. (eds) Handbook of Psychopharmacology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-4042-3_4

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