Neurological Symptoms in Pharmacotherapy of Psychoses.

After introduction of the phenothiazines in the therapy of psychoses it was soon evident that these compounds produce a series of so-called extrapyramidal symptoms (Labhardt, 1954) besides the anti-psychotic effect. It has been much discussed whether the extrapyramidal symptoms are a necessary condition for obtaining anti-psychotic effect (Fliigel, 1956) or an inevitable consequence of the treatment (Haase, 1961 ), or a therapeutically beneficial effect of the phenothiazines on the central nervous system (Bordeleau & Gratton, 1958; Delay & Deniker, 1959). Several authors conclude that extrapyramidal symptoms are not necessary for obtaining anti-psychotic effect (Faurbye et al., 1959; Goldman, 1961; Cole & Clyde, 1961), and Uhrbrand & Faurbye (1960) regard the extrapyramidal symptoms as harmful side effects and assert that they may be irreversibIe. Cases with chronic extrapyramidal symptoms were also seen by Sigwald at al. (1959) ; Kruse ( 1960) ; Chatagnon et al. (1961) ; Druckman, Seelinger & Thulin ( 1962). In the following are presented some investigations on the so-called extrapyramidal symptoms during long term treatment of psychoses with psychopharmaca and a discussion of the mechanism of their appearance.