December 11th, In 1951, in the labs of the French pharmaceutical company Rhône Poulenc, chemist Paul Charpentier formulated a drug that would change the field of psychiatry forever.
Charpentier had no intention of starting a revolution. He was actually trying to make a better antihistamine. However, tweaking an existing drug called promazine led him to create a new compound called chlorpromazine, which he named Henri Laborit, who was searching for a more effective anesthetic. was handed over to the surgeon. He found it to have a sedative effect on his patients, and in 1952 Laborit persuaded colleagues at a military hospital in Paris to administer the drug to his 24-year-old man suffering from psychosis. After 20 days of treatment, the man was ready to “get back to normal life.” No one knew how the drug would work, but it exploded in popularity in the United States and Europe as a treatment for psychosis, giving birth to the antipsychotic drugs we know today.
Around the same time, it was found that drugs used to increase the release of the neurotransmitter dopamine, such as amphetamine, could lead to the development of psychotic symptoms. Tampering with dopamine levels has become a cornerstone of schizophrenia treatment and laid the foundation for the dopamine hypothesis of schizophrenia. This is the theory that a dysregulated dopamine system causes the symptoms of the condition.
Not much progress has been made in this field since the deluge of discoveries in the mid-20th century. The focus on dopamine has led to antipsychotics becoming the classic treatment for schizophrenia. However, it is notorious for being poorly effective in some patients, completely ineffective in others, and causing unwanted and sometimes overwhelming side effects.
Infuriatingly, the most effective antipsychotic drug for schizophrenia symptoms, clozapine, appeared in the late 1980s, but it has the most unpleasant effects, including weight gain, diabetes, and excessive sleepiness. There is a nature. Ragy Girgis, Associate Professor of Clinical Psychiatry at Columbia University, said: Overall, the weak efficacy and notorious side effects of currently available drugs mean that the majority of people with schizophrenia simply stop taking the drug.
But new drugs are bringing hope to the field. Xanomeline-trospium (KarXT) has a new way of reducing dopamine transmission, which has the potential to reduce symptoms with fewer side effects. “The field has been waiting for something like this for a very long time,” says Sameer Jauhar, a London psychiatrist and lecturer in affective disorders and psychosis at King’s College London. . “I think this is a breakthrough,” says Christoph U. Correll, a professor of psychiatry at Hofstra University in New York. “For 70 years we have been waiting for a new mechanism of action.”
Although dopamine appears to play a key role, the exact triggers of schizophrenia, which affects about 24 million people worldwide, remain unknown. However, it is clear that better treatments are needed. This condition is one of the leading causes of disability worldwide. One of his 20 people with schizophrenia commits suicide, about 80% lose their jobs, and the lifespans of those affected are shortened by 10 to 20 years.
