Category:Neuroleptics: Difference between revisions
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MDElliottMD (talk | contribs) Retrofit to canonical category structure: history-first lead (chlorpromazine, Delay and Deniker, the clozapine story), members indexed by generation, Notes on scope and About these pages; added missing Medicines tag; all citations PMID-verified |
MDElliottMD (talk | contribs) Category:Neuroleptics: repoint generation links to renamed categories; house terminology (task #23 follow-up) |
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The '''neuroleptics''', more widely known as the antipsychotics, are the medicines used to treat psychosis, the disturbances of thought and perception that mark schizophrenia and the other psychotic illnesses, and used as well in the manic and the depressive phases of bipolar disorder.<ref name="calabrese">Calabrese JR, Keck PE Jr, Macfadden W, et al. A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. ''The American Journal of Psychiatry''. 2005 Jul;162(7):1351–1360. PMID: 15994719.</ref> The class has a definite beginning. Chlorpromazine was synthesized in 1950 by the French company Rhône-Poulenc, the compound RP-4560, out of the phenothiazine family that had already given medicine its antihistamines; the surgeon Henri Laborit, using it to settle patients before operations, saw that it produced a striking calm without heavy sedation and pressed psychiatry to try it. In 1952, at hospitals in Paris, the psychiatrists Jean Delay and Pierre Deniker gave chlorpromazine to psychotic patients and published the first clinical reports of what it could do.<ref name="lopezmunoz">López-Muñoz F, Alamo C, Cuenca E, et al. History of the discovery and clinical introduction of chlorpromazine. ''Annals of Clinical Psychiatry''. 2005 Jul-Sep;17(3):113–135. PMID: 16433053.</ref> Its arrival is generally taken as the start of modern psychopharmacology.<ref name="ban">Ban TA. Fifty years chlorpromazine: a historical perspective. ''Neuropsychiatric Disease and Treatment''. 2007 Aug;3(4):495–500. PMID: 19300578.</ref> | The '''neuroleptics''', more widely known as the "antipsychotics", are the medicines used to treat psychosis, the disturbances of thought and perception that mark schizophrenia and the other psychotic illnesses, and used as well in the manic and the depressive phases of bipolar disorder.<ref name="calabrese">Calabrese JR, Keck PE Jr, Macfadden W, et al. A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. ''The American Journal of Psychiatry''. 2005 Jul;162(7):1351–1360. PMID: 15994719.</ref> The class has a definite beginning. Chlorpromazine was synthesized in 1950 by the French company Rhône-Poulenc, the compound RP-4560, out of the phenothiazine family that had already given medicine its antihistamines; the surgeon Henri Laborit, using it to settle patients before operations, saw that it produced a striking calm without heavy sedation and pressed psychiatry to try it. In 1952, at hospitals in Paris, the psychiatrists Jean Delay and Pierre Deniker gave chlorpromazine to psychotic patients and published the first clinical reports of what it could do.<ref name="lopezmunoz">López-Muñoz F, Alamo C, Cuenca E, et al. History of the discovery and clinical introduction of chlorpromazine. ''Annals of Clinical Psychiatry''. 2005 Jul-Sep;17(3):113–135. PMID: 16433053.</ref> Its arrival is generally taken as the start of modern psychopharmacology.<ref name="ban">Ban TA. Fifty years chlorpromazine: a historical perspective. ''Neuropsychiatric Disease and Treatment''. 2007 Aug;3(4):495–500. PMID: 19300578.</ref> | ||
Chlorpromazine reached the French market in 1952 as Largactil and the United States in 1954 as Thorazine, and within a few years it had altered psychiatry's institutions as well as its prescriptions: its introduction is widely held to have helped make possible the deinstitutionalization of the following decades, when large numbers of long-stay psychiatric patients were discharged, though historians are clear that social and policy currents drove that shift alongside the medicine.<ref name="lopezmunoz"/> The class has carried several names. The earliest, "major tranquilizer", described the calm; "neuroleptic", from Greek roots meaning roughly to take hold of the nerve, came into use in the 1950s; "antipsychotic" spread in the 1960s. The newest term is the most confident, naming a disease the medicine is supposed to act against, and it sits a little ahead of the science, for the dopamine hypothesis of psychosis on which it rests remains a matter of genuine debate.<ref name="lyman">Lyman M, McCutcheon RA. Antipsychotic drugs at 75: the past, present, and future of psychosis management. ''British Medical Bulletin''. 2025 Sep;156(1):ldaf016. PMID: 41052274.</ref> | Chlorpromazine reached the French market in 1952 as Largactil and the United States in 1954 as Thorazine, and within a few years it had altered psychiatry's institutions as well as its prescriptions: its introduction is widely held to have helped make possible the deinstitutionalization of the following decades, when large numbers of long-stay psychiatric patients were discharged, though historians are clear that social and policy currents drove that shift alongside the medicine.<ref name="lopezmunoz"/> The class has carried several names. The earliest, "major tranquilizer", described the calm; "neuroleptic", from Greek roots meaning roughly to take hold of the nerve, came into use in the 1950s; "antipsychotic" spread in the 1960s. The newest term is the most confident, naming a disease the medicine is supposed to act against, and it sits a little ahead of the science, for the dopamine hypothesis of psychosis on which it rests remains a matter of genuine debate.<ref name="lyman">Lyman M, McCutcheon RA. Antipsychotic drugs at 75: the past, present, and future of psychosis management. ''British Medical Bulletin''. 2025 Sep;156(1):ldaf016. PMID: 41052274.</ref> | ||
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The neuroleptics are grouped, as psychiatry groups them, into three generations, which mark the order in which they reached use and broadly track their side-effect profiles. | The neuroleptics are grouped, as psychiatry groups them, into three generations, which mark the order in which they reached use and broadly track their side-effect profiles. | ||
* '''[[:Category:First- | * '''[[:Category:First-generation neuroleptics|First generation (typical)]]''': the medicines of the 1950s onward, dopamine D2 antagonists carrying the greatest burden of movement-related effects. [[chlorpromazine]], [[fluphenazine]], [[perphenazine]], [[trifluoperazine]], [[prochlorperazine]], [[thioridazine]], [[thiothixene]], [[loxapine]], [[molindone]], [[haloperidol]], [[droperidol]], and [[pimozide]]. | ||
* '''[[:Category:Second- | * '''[[:Category:Second-generation neuroleptics|Second generation (atypical)]]''': fewer movement effects, more metabolic ones. [[clozapine]], [[risperidone]], [[paliperidone]], [[olanzapine]], [[quetiapine]], [[ziprasidone]], [[asenapine]], [[iloperidone]], [[lurasidone]], and [[lumateperone]]. | ||
* '''[[:Category:Third- | * '''[[:Category:Third-generation neuroleptics|Third generation]]''': the dopamine partial agonists, which modulate dopamine signaling rather than simply blocking it. [[aripiprazole]], [[brexpiprazole]], and [[cariprazine]]. | ||
== Notes on scope == | == Notes on scope == | ||
This category indexes the neuroleptics: the medicines whose defining use is the treatment of psychosis, grouped above by generation. The boundary is that | This category indexes the neuroleptics: the medicines whose defining use is the treatment of psychosis, grouped above by generation. The boundary is that action against psychosis, however the individual medicine achieves it. | ||
Several neuroleptics are used well beyond psychosis, and are cross-indexed accordingly. Many of the second- and third-generation agents are central to the treatment of bipolar disorder, in mania and in depression alike; some, quetiapine among them, are used at low doses for sleep or for anxiety; and a few first-generation phenothiazines, prochlorperazine in particular, are used more often as antiemetics than as antipsychotics. Following the wiki's multi-membership convention, a medicine is indexed wherever its pharmacology and its uses warrant. | Several neuroleptics are used well beyond psychosis, and are cross-indexed accordingly. Many of the second- and third-generation agents are central to the treatment of bipolar disorder, in mania and in depression alike; some, quetiapine among them, are used at low doses for sleep or for anxiety; and a few first-generation phenothiazines, prochlorperazine in particular, are used more often as antiemetics than as antipsychotics. Following the wiki's multi-membership convention, a medicine is indexed wherever its pharmacology and its uses warrant. | ||