History of Psychopharmacology

by Evan Kemp

Psychopharmacology originated in the early nineteenth century with the recreational and experimental human use of organic drugs and medicines (Muller, Fletcher, & Steinberg, 2006). Plant-derivatives such as tea and opium were freely accessible in the oriental region; tobacco and coffee in America and alcohol prevalent worldwide (Hamilton & Timmons, 1994). As time progressed, scientists became progressively curious as to the effects of drugs on animal behaviour. As animal testing evolved, the efficacy of certain drugs and substances became increasingly evident (Domino, 1999). During the latter part of the nineteenth century, newly synthesised alkaloids such as morphine and chloral hydrate were growing in prevalence among asylums and university hospitals. Prior to the advent of chlorpromazine and thioridazine in the 1950s, approximately 500,000 individuals resided within mental institutions in the United States of America. However, the development and utilisation of pharmacologic interventions saw this figure dramatically decrease to approximately 200,000 in-patients within 10 years (Sherr, 2000). The term psychopharmacology was first used in the early twentieth century and the modern history of psychopharmacology starts with the synthesis of chlorpromazine (Muller, Fletcher, & Steinberg, 2006). The term psychopharmacology as it is known today refers to the effect of certain medications on an individuals’ mind and behaviour (Sherr, 2000).
Psychoactive drugs are typically utilised to alter mood or treat psychopathology. Drugs used to alter mood or consciousness are categorised based on their influence on the central nervous system. These drugs are classified as a stimulant, depressant or hallucinogen and each yield differing outcomes (Hamilton & Timmons, 1994). Drugs utilised to treat psychopathology, however, can be classified into three categories based on the type of symptoms they aim to alleviate. Drugs classified as antianxiety are used to reduce anxious feelings experienced during day-to-day activity. Antidepressant drugs aim to alleviate negative feelings which may range from sombre, to depressed, to suicidal ideation. Finally, antipsychotic drugs are used to treat severe forms of mental illness in which the individual may experience delusions or feelings of grandeur and might be at risk of harming themselves or others (Hamilton & Timmons, 1994).
A revolution for the field of psychiatry was the development of electro-convulsive therapy (ECT), insulin coma therapy and psychosurgery during the early twentieth century (Kaplan & Sadock, 1998). Research focussed on the therapeutic benefits of therapies and medications became vital to the development of psychoactive medication. Australian psychiatrist John Cade, in 1949, discovered the therapeutic benefits of lithium as a treatment for manic behaviour when he noted lethargy in animal subjects (Kaplan & Sadock, 1998). In 1950, psychiatrists worldwide were praising the benefits of chlorpromazine as an efficacious treatment for agitation and psychosis. Following the introduction of chlorpromazine to American psychiatry, psychotherapeutic drugs became a foundation of psychiatric treatment (Kaplan & Sadock, 1998).
Over the following decade the prescription of antidepressant, antianxiety and antipsychotic drugs became common practice among psychiatrists. The next 30 years were dedicated to clinical trials to demonstrate the effectiveness of each class of drug and drug sub category. Psychiatric research post-1960 has seen many additions to the psychotherapeutic drug range. For example, research has demonstrated the serotonin-dopamine antagonists such as risperidone and clozapine as efficacious against positive and negative symptoms of schizophrenia (Kaplan & Sadock, 1998). Further, advances in Alzheimer’s medication, anti-depressants and anticonvulsants have seen the quality of life for many improve, with continued research assessing the clinical viability of many new and innovative psychotherapeutic medications.