Evolution of antipsychotics and their use in the treatment of schizophrenia. What´ s up, doc?

Abstract

The modern era in the treatment of psychoses began with the synthesis of chlorpromazine in 1950. In the ‘60s it was already known that first generation antipsychotics were quite effective to reduce the positive symptoms of schizophrenia and allowed the de-institutionalisation of many people. In the ‘70s and ‘80s, research focused mainly on indications of antipsychotics and the benefits and risks of long-term pharmacotherapy. During the ‘90s, the rise of atypical or second generation antipsychotics generated enormous expectations about the possibility of further improving the treatment of schizophrenia. But in recent years we have seen that many of those expectations couldn’t be met. This article reviews what happened with antipsychotics and their place in the treatment of schizophrenia in the past 20 years, and propose hypotheses about the reasons for that enthusiasm and subsequent disenchantment. 

"Este artículo fue publicado por primera vez en Vertex, Revista Argentina de Psiquiatría 2011, XXII (100): 423-429. Se reproduce aquí su versión original revisada por la autora."