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Chapter 13. TREATMENT OF MENTAL PATIENTS

PSYCHOPHARMACOLOGY

The main method of treating various psychopathological syndromes is therapy with psychotropic agents, which has been first used by French researchers J. Delay and P. Deniker in 1952. They introduced the term "neurolitics" to refer to such agents and then began to call them antipsychotics. At that time, the main antipsychotic was chlorpromazine. Shortly after, P. Jansen (1958) introduced the second, extremely important antipsychotic - haloperidol, which until now is the reference preparation of psychotropic action. In Russia, chlorpromazine was synthesised under the name Aminazine by M. Shchukina in 1957; after that, Propazine was obtained chemically; this preparation did not contain a chlorine atom and, therefore, did not cause sizeable side effects in contradistinction to chlorpromazine.

Since 1957, preparations which are chemically similar to chlorpromazine (Aminazine) (containing the phenothiazine ring), but having an impact on depression. They became the first antidepressants and were called "antidepressants of a tricyclic structure": these are imipramine (Melipramine), amitriptyline, etc. The mechanism of antidepressant action of this group's preparations was studied and described by the American researcher J. Axelrod in 1960. He discovered that the neurochemical basis of antidepressant effect of these tricyclic structures was a direct influence on the presynaptic uptake of serotonin and noradrenaline in synapses of CNS neurons; for this, the author was awarded the Nobel Prize. Pipofezine (Azaphen) became the first Soviet antidepressant; it was studied by M.D. Mashkovsky, and later he created a four-cycle antidepressant pirlindole (Pirazidol).

In 1954, Leo Sternbach synthesised the first tranquilliser of the benzodiazepine structure, which was called "chlordiazepoxide" (Elenium).

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