Archives for Drugs
By rights, lithium should come first in a discussion of the first drug set, because its effectiveness was discovered — or more properly rediscovered — in 1949, just around the same time as mephenesin. The use of lithium in psychiatry — as a hypnotic — was first described in 1870 by Silas Weir Mitchell, a socially prominent Philadelphia neurologist with a large private practice. Lithium is an important treatment, remaining ... Read More
Tricyclic Antidepressants
Posted By Kelly On Tuesday, May 10th 2011 under: Drugs
The success of chlorpromazine wonderfully concentrated minds in the pharmaceutical industry. The discovery did seem capable of being reproduced. Chlorpromazine's phenothiazine nucleus — two phenyl rings held together with a nitrogen and a sulfur atom (giving the impression of three rings) — had been synthesized in 1883 by August Bernthsen in his laboratory in Heidelberg. It was the basis of numerous dyes, and medicinal chemists were entirely familiar with it. ... Read More
Energizers
Posted By Kelly On Tuesday, May 10th 2011 under: Drugs
In 1957 Hoffmann-La Roche secured from the FDA a depression indication for iproniazid, their drug brand-named Marsilid, that had been on the market for tuberculosis since 1951. Marsilid worked in psychiatry by inhibiting the action of a brain enzyme, and was the first of the anti-depressants with efficacy in melancholia. It was not initially billed, however, as an antidepressant. Belonging to a class called "monoamine oxidase inhibitors" (MAOIs), it was ... Read More
Chlorpromazine and the Phenothiazines
Posted By Kelly On Tuesday, May 10th 2011 under: Drugs
Yet the concept of tranquilizer was validated in the usefulness of chlorpromazine and other phenothiazine antipsychotics as antidepressants. Antipsychotics as antidepressants: a fateful notion, for if the concept had survived, the subsequent division of illness into separate categories might not have occurred; and later developments do indeed appear as a colossal historic error, the separation of a bucket of water into neat compartments for purposes of commercial advantage. But in ... Read More
Dissolving the Tranquilizer Unity
Posted By Kelly On Tuesday, May 10th 2011 under: Drugs
In the late 1950s the tranquilizer spectrum started to be hammered apart with the reification of specific drug categories such as antipsychotics, antidepressants, and anxiolytics as separate classes for distinct diseases. But this dissolving of the tranquilizer unity actually began as early as 1955 when Paris psychiatry professor Jean Delay christened the phenothiazines as neuroleptics, a drug class that included chlorpromazine as well as reserpine. It was a drug class ... Read More
Meprobamate
Posted By Kelly On Tuesday, May 10th 2011 under: Drugs
As the Ritalin story was unfolding, Frank Berger was searching for a longer-acting mephenesin, the drug with such salutary effects on cerebral palsy at the University of Rochester Medical School. Henry Hoyt, president of Carter Products, a company that had come up on "Carter's Little Liver Pills" in the nineteenth century (they were thought super-effective because they turned your urine green), was hunting for some way of getting in on ... Read More
Methylphenidate
Posted By Kelly On Tuesday, May 10th 2011 under: Drugs Tags: ritalin-depression-treatment
It is difficult for clinicians of the twenty-first century to accept that they might be offering their patients medications that are less effective than those available in the past. But the historical evidence is difficult to overlook.
In the early 1950s, a stream of new psychiatry drugs began to pour onto the market, although the psychoanalytically oriented psychiatrists of the day were really the last to prescribe them, and family doctors ... Read More
Although mephenesin was the first tranquilizer, it wasn't billed as one. Philadelphia psychiatrist Benjamin Rush initially used the term tranquilizer, early in the nineteenth century, to refer to a chair into which mad patients were strapped. The word then went out of fashion for the next century and a half, when the modern use of the term was initiated by Ciba pharmacologist Frederick F. Yonkman in 1953 in an internal ... Read More
Mephenesin
Posted By Kelly On Tuesday, May 10th 2011 under: Drugs
It is the Second World War. Frank Berger, a Jewish refugee from Nazi Germany who was born in Pilsen, Austro-Hungary, in 1913 and graduated in medicine in Prague in 1937, has made his way to England and taken a job with British Drug Houses. Having a strong background in chemistry, he directs in 1946 the pharmacological study of a drug called mephenesin, a glycerol ether synthesized in 1908. "So before ... Read More
Drug interactions: cytochrome P450. Part 8
Posted By Kelly On Monday, November 9th 2009 under: Drugs Tags: Drug Interaction, Medications
Role of Pharmacist
There is no guide, chart, or computer software program for clinicians to clearly identify or quickly predict which drugs interact with the CYP enzymes and create clinically significant drug interactions in patients. More research and clinical drug trials need to be conducted and reported on these enzymes and their interactions. With the knowledge of how cytochrome P450 enzymes enzymes work and of their physiologic role ... Read More