Psychofarmakologia – Quo vadis?
Psychopharmacology is the field of knowledge concerning drugs acting specifically on distinct psychopathological symptoms such as e.g. psychosis, depression, mania, anxiety, etc. The birth of contemporary psychopharmacology was heralded by a paper by Australian psychiatrist, John Cade, in 1949, describing the therapeutic action of lithium in mania and a paper by French psychiatrists from 1952 demonstrating the therapeutic action of chlorpromazine on psychotic symptoms. Here, the development of antipsychotic, antidepressive, mood-stabilizing (preventing affective recurrences), anxiolytic and pro-cognitive drugs is outlined. Based on the chronology of their introduction into psychiatric treatment and the therapeutic spectrum, three generations of antipsychotic drugs can be distinguished, and two antidepressive and mood-stabilizing drugs. Despite a great accumulation of knowledge on brain function, the mechanism of the majority of psychotropic drugs can be interpreted by their effect on brain neurotransmitters (subtypes, receptors, transporters) such as dopamine, serotonin, noradrenaline, glutamate, and acetylcholine. In the paper, the directions of the development of psychopharmacology, the possibilities of using psychedelics and the like as psychotropic drugs, and the role of psychotherapy in pharmacological context are delineated. Finally, the ongoing controversies on antidepressant drugs, increasing for three decades, are presented, achieving a great media reaction, also in Poland.