By Peter F. Liddle (auth.), Dr. Bart A. Ellenbroek, Dr. Alexander R. Cools (eds.)
The advent of chlorpromazine in 1953, and haloperidol in 1958, into medical perform dramatically altered the remedy of schizophrenic sufferers. even supposing representing on no account a treatment for this critical psychiatric ailing ness, it allowed, for the 1st time, to safely keep an eye on the serious hallu cinations and delusional ideals which stop those sufferers from prime a roughly self reliant lifestyles. certainly those antipsychotics (and the various congeners that have been to stick with) considerably diminished the quantity ofchronic schizophrenic inpatients in psychiatric clinics worldwide. even if quickly after their creation it grew to become transparent that, like several different to be had medications, antipsychotics have been not at all miracle medicinal drugs. in reality, significant difficulties seemed. First, the antipsychotics had little or no impression at the so-called detrimental or disorder indicators, like social isolation, apathy and anhedonia, and secondly almost all antipsychotics produced a few side-effects, of which the neurological (often known as additional pyramidal) side-effects have been the main tricky. specifically the tardive dyskinesia, which happened in approximately 15 to twenty% of the sufferers after seasoned longed remedy, represented an enormous challenge within the therapy of schizo phrenic patients.
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References I Baldessarini RJ, Kando JC, Centorrino F (1995) Hospital use of antipsychotic agents in 1989 and 1993. Am J Psychiat 152: 1038-1044 2 Deniker P (1983) Discovery of the clinical use of neuroleptics. In: MJ Parnham, J Bruinvels (eds): Discoveries in pharmacology, Vol 1: Psycho- and Neuropharmacology. Elsevier, Amsterdam, 163 - 180 3 Ellenbroek BA (1993) Treatment of schizophrenia: a clinical and preclinical evaluation of neuroleptic drugs. Pharmacol Ther 57: 1-78 4 Johnstone EC (1993) Schizophrenia: problems in clinical practice.
Cools Clinical Starting Point Drug has therapeutic value in humans ~ ,. Yes Screening Model Development Drug has clear effects in animals ~ Screening Model ValidatIon New Drug Discovery New Drug Evaluation +NO I ,. Yes New drugs have same effect as standard ~ +NO ,. Yes Model has similarity with clinical situation ~ +NO +NO ,. Yes Evaluate new drug in clinical trials Figure 2. A flow diagram illustrating the most important steps in developing screening models. absolute prerequisite. Moreover a parameter measured on a ratio or interval scale is preferred over a parameter on a nominal or ordinal level.
Since psychotherapeutic drugs produce a large number of effects (both beneficial and unwanted), it is important to determine whether the effects observed in the screening model predict the therapeutic action of psychotherapeutic agents or one of the side-effects. For this purpose a number of criteria have been developed largely based on the clinical pharmacology of these drugs [5, 27]. The criteria for evaluating the validity of a screening model can be subdivided into two categories: general and specific.
Atypical Antipsychotics by Peter F. Liddle (auth.), Dr. Bart A. Ellenbroek, Dr. Alexander R. Cools (eds.)