History of Neuroleptics/Antipsychotics

Neuroleptic/anti-psychotic drugs originate from the chemical phenothiazene, which was used as synthetic dye in 1883. In 1934 Phenothiazene was used by the veterinary practice as an insecticide and extended for killing swine parasites; phenothiazene affects the brains Acetlycholinergic System and results in lethal increases of acetlycholine in the periphery and central nervous system of the insect.
Mad in America (www.madinamerica.com)
provides a longer history of neuroleptics.

In France, Delay and Deniker (1952), discovered that Largactil helped to ameliorate hallucinations and delusions. Years later, pharmaceutical companies discovered that Largactil reduced dopamine production in the brain. The conclusion drawn from these two observations was the belief that schizophrenia was a brain disease, which resulted from an excess of dopamine production in the brain.

In reality this theory has no confirmed basis since there is no test to prove that psychosis is the result of the excess of dopamine. However through out the world when patients symptomology fit into the Schneider (1957) criteria of First Rank Symptoms, neuroleptics/anti-psychotics are prescribed for the diagnosis of 'schizophrenia'. The biological hypothesis or the Medical Model is the primary and dominant choice of 'treatment' (italics used as treatment is applicable only to specific illnesses which can be proved). Many mental health practitioners believe unless 'schizophrenia disease' is 'treated' early with neuroleptics the 'disease' will progress, even though there is no valid proven test for the 'disease'.

This attitude dominates psychiatry resulting in many practitioners sincerely believing they are failing their patients if they withheld neuroleptic 'treatment'. Many practitioners are unaware that psychosis can be ameliorated, with patients being treated successfully without neuroleptics/anti-psychotics (Irwin 2004)

The UK national NICE Guidelines for Schizophrenia compounds the situation in their recommendation of neuroleptics/antipsychotics for 'schizophrenia'. (National Institute for Clinical Excellence 2002) and further down the line local Care/Foundation Trust Guidelines follow suit; psychiatrists may be under pressure to prescribe for fear of career repercussions and loss of professional status.

Typical and atypical neuroleptics
In the 1950’s, Stelazine, Haloperidol as well as Largactil were all classified major tranquillizers used to ‘treat’ acute anxiety and positive and negative symptomology of 'schizophrenia'. Positive symptoms include the phenomena of hallucinations, delusions and thought disorder. Negative symptoms include blunting of affect, poverty of speech, and lack of drive, pleasure and poor attention. The major tranquilliser terminology eventually changed to anti-psychotics (essentially neuroleptics as they grab hold of the nerve endings in the brain)as newer drugs were developed. The older neuroleptics are classified as "typical", with the newer ones being classified as "atypical". The typical drugs are relatively inexpensive and cause severe side effects in comparison with the more expensive atypical drugs, which are reputed to cause fewer side effects.

‘As we become better at detecting the core symptoms of schizophrenia patients have worsening mortality ratios’
Sara et al (2007)