PubMed1994
When chlorpromazine was introduced into psychiatric therapy in 1952 and thus the modern psychopharmacological era was started, the situation in psychiatry was deplorable. The psychiatric hospitals were overcrowded and obsolete, complementary institutions were widely missing. In Germany, even after introducing the neuroleptic era and the beginning of the thymoleptic epoch in 1957, no decisive improvement took place at first. As late as in the 70s successes of psychiatric reform efforts in the sense of humanization became visible, along with modern psychopharmacotherapy making an important contribution to these improvements. With the social attitude towards the mentally ill changing, this contribution became effective. In 1954 the antipsychotic efficacy of Rauwolfia alkaloids was described; in 1958 the butyrophenones, especially haloperidol, were introduced. In 1957 the antidepressive efficacy of imipramine was discovered, in the same year the psychiatric importance of monoaminoxidase inhibitors was defined. In 1949 Cade published his findings on the antimanic effect of lithium salts. As tranquilizers meprobamate (1955) and chlordiazepoxide (1960) were made available. In 1966 clozapine was introduced. Objections to psychopharmacotherapy, which were not always objective, were often raised. The biochemical research in cooperation with psychopharmacology has made progress, yet the target of clarification of the pathophysiology of the main psychoses has not been reached as yet. At present there is considerable resistance towards a further expansion of psychopharmacology, research being hampered by legal reglementation and bureaucracy. This development must be faced. Psychopharmacotherapy is not yet sufficiently effective and safe; it must be improved.