Psychotropic Drugs
Psychotropic drugs have revolutionized the treatment of mental illness, perhaps most profoundly in schizophrenia and depression. Psychotropic is a word derived from the Greek psyche, meaning "the mind," and tropos, to "turn or change." Psychotropic drugs are used to treat people with: 1) Clearly diagnosed primary psychiatric illness as defined by the Diagnostic and Statistics Manual of Mental Disorders, (DSM- IV); 2) certain medical conditions--such as specific types of epilepsy; 3) emotionally distressing and extreme behavior which drastically interfere with a person's ability to function; 4) severe dysfunctions resistant to other types of treatment; 5) withdrawal difficulties associated with other psychotropic medications, alcohol, nicotine, caffeine, and opiates; and 6) sedation during dental or medical procedures not requiring anesthetics. Psychotropic drugs fall into four primary categories: antipsychotics, mood stabilizers, anti-anxiety agents, and antidepressants. Each drug is specifically designed and/or prescribed to alter abnormal thought (such as hallucinations, delusions, distortions, and paranoias), abnormal moods (such as extremes of euphoria and depression), and disruptive behaviors (especially those caused by delusions of grandeur or paranoia).
Mental illnesses have been recorded throughout history: Babylonians and Egyptians believed demonic possession to be the cause and used magic, religious rites, or plants and herbs as "cures." Hippocrates attributed "hysteria" to a woman's uterus, and blamed "melancholia" (depression) on black bile, which he attempted to treat with purgatives. Roman writer, Cicero (106-43 B.C.), defied these theories by suggesting melancholia was psychological and that individuals were responsible for the way they thought or felt. Thus began the conflict about the cause of mental illness--was it psychological and treatable with "talk therapy" (psychotherapy); or was it biological requiring medication? While this discussion still rages today and psychotherapy plays an important role in the treatment of many mental illnesses, psychotropic drugs have positively affected the lives of millions of mentally ill people previously untreatable.
Although synthetic sedatives appeared around the late 1800s and barbiturate use began in the early 1900s, 1949 saw the first truly revolutionary treatment of mental illness when Australian psychiatrist, John F. J. Cade, accidentally discovered the amazing benefit of lithium in manic-depression (bipolar disorder). This psychotropic drug is classified as a mood stabilizer. The antipsychotic drug, chlorpromazine (Thorazine), initially developed as an antihistamine, revolutionized the treatment of schizophrenia with its introduction in 1954. Within eight months of its release, more than two million patients were taking it, many of whom left mental institutions to lead relatively normal lives. Haloperidol (Haldol), clozapine (Clozaril), risperidone (Risperdal), and olanzapine (Zyprexa), are also effective in treating psychoses. In the late 1950s, the antidepressant imipramine (Tofranil) became the first of several tricyclic antidepressants to meet with considerable success in treating depression. In 1980s, monoamine oxidase inhibitors gained increased popularity in treating certain types of depression not responsive to the tricyclics, and the selective serotonin reuptake inhibitors--the first being Prozac introduced in the late 1980s--gained immense popularity for their effectiveness, even for people suffering from life-long depression. Barbiturates, highly addictive and sedative antianxiety agents widely prescribed until the 1960s, were replaced by benzodiazepines such as chlordiazepoxide (Librium). In the early 1990s, six of the highest-selling prescription drugs in the U.S. were benzodiazepines.
Undoubtedly, ever-increasing knowledge about the function of the brain will allow more specific development and targeted prescription of psychotropic medications, while research into adjunct therapies--such as light therapy for seasonal affective disorder--and genetics will all play an important role in controlling and alleviating mental illness.
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