Current Medical Diagnosis & Treatment in Psychiatry

Neuropsychopharmacology: Introduction

An understanding of neuropsychopharmacology provides a basis for sound therapeutics. Used as tools to probe the central nervous system (CNS), psychotropic drugs have contributed more than anything else to our understanding of the function of the brain. They have helped to establish biological psychiatry as a branch of medicine, and they have contributed to the generation of heuristic hypotheses concerning the biological basis of mental illness.

Neuropsychopharmacology reached prominence as a consequence of seminal contributions made by a number of basic scientists and astute clinical psychiatrists. Many of these contributions are acknowledged in the individual sections of this chapter. 

A few had such a lasting impact on the field that they deserve to be mentioned briefly at the outset. Otto Loewi and Sir Henry Hallett Dale provided the first real proof of chemical mediation of nerve impulses and established the concept of neurohumoral transmission. A corollary to the chemical transmission concept is the evolution of receptor theory, through the work of Paul Ehrlich on chemoreceptors and John Newport Langley’s concept of receptive substances in the early 20th century. The impact of the receptor theory of Ehrlich and Langley was minimal during their lifetime but is now a major research area in neuropsychopharmacology. Another major milestone in our understanding of hormone and neurotransmitter function was the development of the second messenger concept in the mid-1960s by Earl Sutherland. Sutherland was the first to describe the action of a hormone (epinephrine) at a molecular level. What receptors are—how they work and how psychotropic drugs directly or indirectly interact with various receptor cascades—is a major topic to be discussed in this chapter.

The remarkable contributions of B. B. Brodie and the Brodie School have opened up the field of biochemical psychopharmacology. Discoveries made in Brodie’s laboratory have paved the way for the era of cytochrome P-450 and the pivotal role of the metabolic disposition of drugs as well as the use of drugs as formidable tools to investigate brain function.

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