Observations obtained from carefully studied individual cases and from mass experiments would indicate that the tranquilizing drugs act by suppressing the patient’s symptomatology. They suppress certain clinical manifestations in the patient in the same way as an anti-epileptic drug suppresses epileptic discharges. From a clinical point of view this is a real accomplishment. However, we have at present no indication that any of these compounds will touch upon the substructure of the psychotic individual, or that they influence qualitatively the matrix on which the psychosis develops. These compounds quantitatively influence the patient’s symptoms by reducing their intensity to a varying degree thereby enabling the patient to function. In many instances this reduction in the intensity of symptoms will need psychotherapeutic supplementation in order to solve some of the patient’s conflicts.
The integration of the drug therapies with other forms of psychiatric treatment will be the most important contribution of psychiatric research and therapy in our day. As usual, if some new therapeutic agent is introduced, we observe negation on the one hand and exaggeration on the other. We believe that pharmacotherapy is definite progress in psychiatric treatment and will benefit a number of patients. On the other hand, none of the known chemotherapeutic agents have been so effective that we can say whole psychiatric disorder entities will be wiped out, or as it has been stated, that hospitals will be closing and patients will not be admitted. These chemotherapeutic agents may somewhat reduce the admission rate to hospitals, but this has not been noticeable as yet. We have noted, however, that the discharge rate is higher in the mental hospitals. This may be due to the fact that the period of treatment of the patient can be shortened. There are some indications that patients who have been treated in a hospital and are now maintained on tranquilizing drugs outside of the hospital, do not relapse as often as patients who received other forms of treatment. We need more information on this very important point. If, after a comparatively short period of hospitalization, we could treat many of these patients, even if only on a symptomatic level and on an outpatient status, with the compounds we are using today for the treatment of psychoses such as schizophrenia, it would be a considerable achievement. We would like to call your attention to the fact that without any great fanfare and without even considering it spectacular, 80 per cent of epileptic patients are today controlled with the different chemical compounds now available, outside the hospital. This has been accomplished even though the etiology of epilepsy is unknown and the action of the chemical compounds on the epileptic disorder results in only symptomatic relief but does not affect the etiology.
The use of chemical compounds in psychiatry will be not only a symptomatic tool in controlling more effectively than heretofore some of the psychiatric disorders, but will lead inevitably to intensified research and a better understanding of the biochemical function of the nervous system and also a better understanding of the function of the nervous system in relation to emotional disorders.