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The most outstanding novel of the Spanish literature, Don Quixote, represents the source to which the different specialists who intend to deepen their knowledge of the late Renaissance society usually address. This masterpiece of Miguel de Cervantes has been frequently approached from the psychopathological perspective to obtain a psychiatric diagnosis of its main character, Alonso Quijano. Also, other clinical approaches from the traumatological and general therapeutical view (oils, ointments, balms and other pharmacy preparations) have been frequent. We have tackled Don Quixote from the psychopharmacological perspective, a barely explored field. In this work, we intend to study the therapeutical cures used during the Cervantine time for the treatment of insane and mentally disturbed people (sedatives like opium, laxatives like hellebore, tonics, irritants and surgical techniques like bloodlettings and "fuentes") and we analyze the limited and unspecific therapies, mainly of herbal origin (balms, purgatives and emetics), which Cervantes reveals to us in his novel. Among them, rhubarb root (Rumex alpinus), seeds of spurge (Euphorbia lathyris), St. John's Wort (Hypericum perforatum), main ingredient of Aparicio's oil, and rosemary (Rosmarinus officinalis), primary component of the famous balsam of Fierabras, should be highlighted. We have also examined the possible scientific influences which might have inspired Cervantes in this field, mainly the works of Juan Huarte de San Juan The examination of men's wits and the one of Andres Laguna Dioscorides' materia medica. [ABSTRACT FROM AUTHOR]

The treatment of ADHD has focused on the use of psychostimulants drugs such as methylphenidate or amphetamine and derivatives, or not stimulants agents, such as atomoxetine. These agents act mainly on catecholaminergic presynaptic mechanisms. Recently the European Medicines Agency (EMA) has approved another not psychostimulant drug, guanfacine extended release (ER), as a new option to the treatment of ADHD, which acts at postsynaptic level. Guanfacine stimulates postsynaptic alfa-2A adrenergic receptors so it inhibits the production of cAMP and closes HCN channels enhancing the effectiveness of the signal of the pyramidal neurons of the prefrontal cortex (PFC), thus improving working memory and attention. In addition, stimulation of the alpha-2A receptors promotes growth and maturation of the dendritic spines of pyramidal neurons of the medial PFc, that are associated with brain function such as learning and memory. In contrast with psychostimulants or atomoxetine, guanfacine mimics noradrenaline stimulation of postsynaptic receptors alfa-2A on the PFC.

Objectives: We carried out a bibliometric study on the scientific publications in relation to atypical antipsychotic drugs (AADs) in Spain., Methods: We used the EMBASE and MEDLINE databases and we applied some bibliometric indicators of paper production and dispersion (Price's law and Bradford's law, respectively). We also calculated the participation index of the different countries and correlated the bibliometric data with some social and health data (total per capita expenditure on health and gross domestic expenditure on research and development)., Results: We collected 656 original papers published between 1988 and 2011. Our study results fulfilled Price's law with scientific production on AADs showing exponential growth (correlation coefficient r = 0.9693, vs. r = 0.9177 after linear adjustment). The most widely studied drugs were risperidone (181 papers), olanzapine (143), clozapine (94), and quetiapine (74). Division into Bradford zones yielded a nucleus occupied by the European Psychiatry and European Neuropsychopharmacology (70 articles). Totally 194 different journals were published, with 5 of the first 10 used journals having an impact factor being greater than 4., Conclusion: The publications on AADs in Spain have undergone exponential growth over the studied period, without evidence of reaching a saturation point.

The serendipity is the faculty for making a discovery through a combination of accident and sagacity. In psychopharmacology, the serendipity played a key role in the discovery of many psychotropic drugs, although there are marked disputes in this regard, possibly due to semantic differences in relation to the meaning of this term. We have implemented an operational definition of serendipity based on the discovery of something unexpected or not sought intentionally, irrespective of the systematic process leading to the accidental observation. The present paper analyses some representative examples of discoveries in the field of psychopharmacology according to different serendipitous intervention patterns. Following this approach there would be four different imputability patterns: pure serendipitous discoveries (valproic acid/valproate); serendipitous observation leading to a non-serendipitous discoveries (imipramine); non-serendipitous discoveries secondarily associated with serendipitous observation (barbiturates); non-serendipitous discoveries (haloperidol). We can conclude that pure serendipitous discoveries in this field are not very frequent, most common being a mixed pattern; an initial serendipitous observation which leads to a non-serendipitous discovery of clinical utility. This is the case of imipramine, lithium salts, chlorpromazine or meprobamate.

The most outstanding novel of the Spanish literature, Don Quixote, represents the source to which the different specialists who intend to deepen their knowledge of the late Renaissance society usually address. This masterpiece of Miguel de Cervantes has been frequently approached from the psychopathological perspective to obtain a psychiatric diagnosis of its main character, Alonso Quijano. Also, other clinical approaches from the traumatological and general therapeutical view (oils, ointments, balms and other pharmacy preparations) have been frequent. We have tackled Don Quixote from the psychopharmacological perspective, a barely explored field. In this work, we intend to study the therapeutical cures used during the Cervantine time for the treatment of insane and mentally disturbed people (sedatives like opium, laxatives like hellebore, tonics, irritants and surgical techniques like bloodlettings and <>) and we analyze the limited and unspecific therapies, mainly of herbal origin (balms, purgatives and emetics), which Cervantes reveals to us in his novel. Among them, rhubarb root (Rumex alpinus), seeds of spurge (Euphorbia lathyris), St. John's Wort (Hypericum perforatum), main ingredient of Aparicio's oil, and rosemary (Rosmarinus officinalis), primary component of the famous balsam of Fierabras, should be highlighted. We have also examined the possible scientific influences which might have inspired Cervantes in this field, mainly the works of Juan Huarte de San Juan The examination of men's wits and the one of Andres Laguna Dioscorides' materia medica.

Introduction: Given that depression is the most prevalent psychiatric disorder in our society, the current situation in pharmacotherapy of depression in Spain has been studied from the point of view of psychiatrists and general practitioners (GP)., Method: A total of 339 interviews were carried out with two groups of physician (238 primary care physicians and 101 psychiatrists) from different Spanish cities. Distribution, application and questionnaires collection were made throughout 2002., Results: The diagnostic instruments most commonly used by more than 90 % of both medical groups to detect a depressive disorder in a consultation are the evaluation of symptoms and the interview with the patient. However the main diagnostic problem was "masking" of depression with other symptoms/disorders. Most GP (95 %) and psychiatrists (99 %) establish a pharmacological treatment in all their depressive patients. Both groups coincide in most community use of SSRI as drugs of first choice (93% from both samples). The pharmacological agents most used by the psychiatrist are the serotonin selective reputake inhibitors (SSRI) (98.3 %), followed by venlafaxine (84.4 %), anxiolytics (68.4 %), mirtazapine (58.9 %) and reboxetine (55.8 %). In the case of GP, the most commonly used pharmacological groups are SSRI (98.3 %) and anxiolytics (73.4 %). In primary care, the SSRI are considered the most effective antidepressant group. However, the tricyclic antidepressives (TCA) would be the most effective for the psychiatrists., Conclusions: For psychiatrists and GP, the quality of care of depression in Spain is rated positively. However, there is a group of deficiencies and some aspects that need to be clearly improved, such as the time of consultations, coordination between GP and psychiatrists, waiting lists and available resources for mental health units.

Reserpine, an alkaloid of the Rauwolfia serpentina plant isolated during the middle of the 20th Century, represented a highly important clinical advance in the treatment of schizophrenia whose pharmacological tools were limited to chlorpromazine that was introduced in the clinical area two years before. Both agents would come into the history as the drugs that made possible the beginning of the psychopharmacological era. In the present article, a revision is made of the complicated process leading to the isolation and synthesis of reserpine, by the Swiss pharmaceutical company Ciba (Schlittler and Müller) and how its pharmacological properties (Bein) were discovered and studied, in the animals laboratory, mainly, the "tranquillizers". The introduction of this antipsychotic in psychiatry, which was initiated in 1954 (half a century ago), and the results obtained in the first clinical studies, as well as the role played by researchers such as Kline, Delay, Noce, Hollister, Altschule, etc. are then described. In addition, and from a historical perspective, the discovery of the adverse effects of this drug, especially those of extrapyramidal nature (dyskinesia and akathisia), are studied, concluding with the reasons that produced its rapid clinical decline, among which the genesis of depressive pictures (phenomenon presently questioned) may be emphasized. Finally, the conclusion reached was that, although the clinical relevance of reserpine was not as evident and long lasting as chlorpromazine, its initial contribution to the treatment of schizophrenic patients was of maximum importance.

Introduction: Recent studies have confirmed the usefulness of the therapeutical combination of two antidepressants from different pharmacological families in patients with single drug therapy resistant depression., Methods: In this prospective 6 weeks open-labeled study, efficacy of combination strategy was evaluated. This included the addition of reboxetine to 34 outpatients with DSM-IV major depressive disorder, who had not responded previously, or who partially responded to conventional treatment in single drug therapy with serotonin selective reuptake inhibitors (SSRI). Data were analyzed on a intent-to-treat basis., Results: Mean decrease in the 21 item Hamilton depression rating scale (HDRS) score was 49.4% (from 26.9 to 13.6; p<0.0001) and in the clinical global impressions scale (CGI) was 40.4% (from 4.6 to 2.7; p < 0.0001). At the end of the treatment, 47.1% of the patients we re considered in remission (HDRS < or = 10), 55.9% evaluated as responders (HDRS < or = 50%) and 58.8% considered as having improvement (CGI<4). No serious side effects were observed during combination therapy, the most frequent being nervousness and the urinary hesitancy (5.9%)., Conclusions: The results of this study suggest that addition of reboxetine to SSRI may be an effective and well-tolerated strategy in treatment-resistant patients who have failed to adequately respond to single drug therapy with SSRI.