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Aspectos asistenciales y farmacológicos sobre la depresión en España en el ámbito de la atención primaria y especializada: situación actual y evolución en los últimos años / Healthcare and pharmacological features of depression in Spain in primary and specialized care: current situation and developments in the last few years

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[A century of barbiturates in neurology]. / Un siglo de barbitúricos en neurologia.

INTRODUCTION AND AIMS: Until the early 20th century, pharmacological treatments for neurological disorders were scarce and inefficient; only bromides stood out as sedating and antiepileptic agents. DEVELOPMENT: The introduction of barbiturates for clinical use in 1904 heralded the beginning of a new age in the pharmacological management of certain neurological pathologies. In this study, we analyse the historical process of the discovery and use of barbiturates in the field of neurology, from the moment it was started by von Baeyer in 1864, with the synthesis of malonylurea, up to the period of the decline of barbiturate therapy in the 1960s. In 1903, von Mering and Fischer discovered the hypnotic properties of barbital and later synthesised phenobarbital (1911). In the years that followed a number of barbiturates, such as butobarbital, amobarbital, secobarbital, pentobarbital, thiopental, and so on, were gradually incorporated into the therapeutic arsenal. During this period, the different therapeutic uses of barbiturates in neurology were analysed, from their traditional use as hypnotic agents (von Husen) to the discovery of the anticonvulsant properties of phenobarbital (Hauptmann) and its use in the treatment of epilepsy. CONCLUSIONS: The barbiturates were one of the first pharmacological tools that proved to be really effective in the management of some neurological disorders. Nevertheless, problems associated with their safety (dependence phenomena and deaths from overdoses), together with the introduction of numerous psychopharmacological agents in the 1950s, ended up eclipsing the use of barbiturates, except for a few very specific cases in which they are still indicated.

Un siglo de barbitúricos en neurología / A century of barbiturates in neurology

Introducción y objetivos. Hasta principios del siglo XX, los tratamientos farmacológicos de los trastornos neurológicos eran escasos y poco eficaces; únicamente destacaban los bromuros como agentes sedantes y antiepilépticos. Desarrollo. Con la introducción clínica de los barbitúricos en 1904, se inicia una nueva era en el abordaje farmacológico de ciertas patologías neurológicas. En este trabajo, se analiza el proceso histórico del descubrimiento y del empleo de los barbitúricos en el ámbito de la neurología, que inició von Baeyer en 1864, con la síntesis de la malonilurea, hasta el período de declive de la terapéutica barbitúrica en la década de los años sesenta. En 1903, von Mering y Fischer descubrieron las propiedades hipnóticas del barbital y posteriormente sintetizaron el fenobarbital (1911). En los años sucesivos fueron incorporándose al arsenal terapéutico, de forma paulatina, numerosos barbitúricos (butobarbital, amobarbital, secobarbital, pentobarbital, tiopental, etc.). Analizamos los diferentes usos terapéuticos de los barbitúricos en neurología durante este período, desde su tradicional empleo como agentes hipnóticos (von Husen) al descubrimiento de las propiedades anticomiciales del fenobarbital (Hauptmann) y su empleo en el tratamiento de la epilepsia. Conclusiones. Los barbitúricos constituyeron las primeras herramientas farmacológicas realmente eficaces en el manejo de algunos trastornos neurológicos. Sin embargo, sus problemas de seguridad (fenómenos de dependencia y muertes por sobredosis), junto a la introducción de una pléyade de psicofármacos en la década de los cincuenta, acabaron por eclipsar el uso de los barbitúricos, salvo en algunas indicaciones puntuales (AU)

Introduction and aims. Until the early 20th century, pharmacological treatments for neurological disorders were scarce and inefficient; only bromides stood out as sedating and antiepileptic agents. Development. The introduction of barbiturates for clinical use in 1904 heralded the beginning of a new age in the pharmacological management of certain neurological pathologies. In this study, we analyse the historical process of the discovery and use of barbiturates in the field of neurology, from the moment it was started by von Baeyer in 1864, with the synthesis of malonylurea, up to the period of the decline of barbiturate therapy in the 1960s. In 1903, von Mering and Fischer discovered the hypnotic properties of barbital and later synthesised phenobarbital (1911). In the years that followed a number of barbiturates, such as butobarbital, amobarbital, secobarbital, pentobarbital, thiopental, and so on, were gradually incorporated into the therapeutic arsenal. During this period, the different therapeutic uses of barbiturates in neurology were analysed, from their traditional use as hypnotic agents (von Husen) to the discovery of the anticonvulsant properties of phenobarbital (Hauptmann) and its use in the treatment of epilepsy. Conclusions. The barbiturates were one of the first pharmacological tools that proved to be really effective in the management of some neurological disorders. Nevertheless, problems associated with their safety (dependence phenomena and deaths from overdoses), together with the introduction of numerous psychopharmacological agents in the 1950s, ended up eclipsing the use of barbiturates, except for a few very specific cases in which they are still indicated (AU)