Antipsychotics as the mainstay of treatment for psychiatric disorders (on the 75th anniversary of the discovery of chlorpromazine)

Background. Antipsychotics, or neuroleptics, have been considered the mainstay of treatment for mental illnesses since their discovery in 1952. The aim of this study was to review publications on the evolution of the development and study of antipsychotics since 1952. Methods. Literature review using the international databases Scopus, Web of Science, and Pub Med. Results. The article describes the key historical events leading to the discovery of chlorpromazine, atypical antipsychotics, and nondopaminergic antipsychotics. This article analyzes A. Carlsson’s (1983) dopamine concept of schizophrenia and the development of antidopamine neuroleptics. The classification, main groups, and pharmacological properties of antipsychotic drugs are considered. Particular attention is given to the development of extended-release forms of neuroleptics, as well as new dosage forms (nasal spray, inhalation, subcutaneous injection). Conclusion. Over a relatively short historical period, the pharmacology of neuroleptics, their mechanisms of action, the limits and indications for use, and the side effects of such therapy have been studied. However, with the discovery of new antipsychotics with different mechanisms of action, a need has arisen for some revision and rethinking of their development and use.