Drug Treatment for Patients with Schizophrenia — A Balance of the Century

Until the mid 20th century the pharmacological management of patients suffering from schizophrenia consisted exclusively of unspecific sedative measures. This situation changed dramatically with the advent of chlorpromazine which had been synthesized by chemists at Rhone-Poulenc in 1950. Originally found successful in manic patients, it was quickly realized that this drug was also very useful to treat agitated patients with schizophrenia and that its effect went way beyond mere sedation (Deniker 1988). After a number of scientific reports in the early 1950s, the term neuroleptic, signifying a “softening of the nervous system” was coined in 1955. The year before, Steck and Haase had independently described the “extrapyramidal and diencephalic syndrome” (Steck 1954) and the “psychomotor Parkinson syndrome” (Haase 1954), thereby recognizing a specific side effect profile of these new medications. In 1958 researchers at Janssen synthesized haloperidol (Niemegeers 1988), which was licensed in 1959. In the same year chlorprothixene, the first thioxanthene neuroleptic, was introduced by Lundbeck (Lassen 1988). The preclinical screening of clozapine started in 1960. Scientists at Dr. Wander AG suggested at first that this drug might be a strongly sedating analgesic (Stille and Fischer-Cornelssen 1988).