The International Journal of Neuropsychopharmacology

Almost half a century ago, a series of remarkable therapeutic developments occurred and were soon recognised as milestones in the history of medicine. The introduction of lithium, chlorpromazine, imipramine and the monoamine oxidase inhibitors, within a few years of each other, radically altered the prospects for treating serious psychiatric disorders. Until then, electroconvulsive therapy had been the only definitive treatment available. Research on pharmacological agents that alleviate disturbances of mood, cognition and behaviour, was given an impetus that led to quantum expansion in the ensuing years. It has become customary to recount the history of neuropsychopharmacology from that time. Although this is an understandable bias, it ignores much fundamental research in neurophysiology, neurochemistry and pharmacology and clinical experimentation with psychoactive agents that laid the foundations for what was to follow. Nevertheless, neuropsychopharmacology is still a very young discipline. This manifests not only in chronology but in the ferment, rapid shifts in priorities and fluidity of fundamental concepts that are hallmarks of youth. The critical observer cannot but concede the likelihood that tenets held basic to contemporary neuropsychopharmacology could turn out to be substantially overemphasised, unacceptably simplistic or even incorrect, in the relatively near future. Perusal of major papers in the field, published no more than one or two decades ago, confirms this impression. Rather than detracting from the discipline, these attributes are what give neuropsychopharmacology its remarkable allure. There is the distinct feeling that much of what can be known has yet to be discovered. Steps equal to or greater in impact than those of half a century ago, wait to be taken.