Phenothiazines and Structurally Related Drugs: Basic and Clinical Studies [antikvár]

Preface It was a great pleasure and honor to welcome the participants to our Fourth International Symposium on Phenothiazines and Structurally Related Drugs. It was gratifying to see many familiar faces; sad to miss somé of the old-timers whose presence at our conferences we took for granted; and encouraging to see many new and young people. For those who are unfamiliar with our periodic Symposia, we should üke to mention that we started our international get-togethers in Paris (1962 and 1967); the third one was held at the National Institute of Mentái Health in Rockville, Maryland (1973). Each of our conferences was structured to reflect the state of the art. We Üke to think that the Proceedings of each of our meetings were useful and provided Information to the research workers in all concerned disciplines for many years. When we first convened in 1962, the clinical know-how was quite advanced. Chlorpromazine had been around for 10 years; had been used therapeutically for almost that long in Europe and Canada; and for a few years less in the United States. Laboratory investigation and development of suitable methodology for the assay of chlorpromazine, its many metabolites, and the new structurally-related drugs that had been introduced rapidly after the success of chlorpromazine, were in their infancy and far from satisfactory. However, somé of the basic aspects of the chemistry of the substituted phenothiazines, particularly the facile formation of free radical derivatives, appeared of interest to the early conferees, clinical as well as basic scientists. We encouraged the clinicians to exchange views with the basic scientists. For the basic scientists, this is imperative: Unless they can design their studies to provide new knowledge on the mode of action of the psychoactive drugs or to provide solid data on what constitutes therapeutic blood concentrations for the various neuroleptics and antidepressants, the cooperation between clinicians and bio-chemists will remain naught but a pious wish. Closer cooperation between clinicians and basic scientists, as it exists presently in only very few hospi-tals, would be tremendously useful for both partners. Thus, good clinical ob-servations by the clinical team could provide reliable information on responders and non-responders in a given drug study. With this information the biochemists could go to work and determine not only blood-drug concentrations, but they could alsó evaluate patterns of drug metabolism and relative abundances of indi-vidual drug metabolites. Somé initial work along these lines has indeed been done, but neither for the metabolites of chlorpromazine nor for those of thiori-dazlne or mesoridazine has the body of data obtained been broad enough to allow sweeping conclusions or valid generalizations to be drawn.