The effect of neuroleptic drugs on paranoid syndromes has been studied. It is insufficient to say that phenothiazines with a piperazine side chain and others have ‘incisive, antipsychotic’ effects (a too vague concept), or excitatory, antihallucinogenic and antidelusional. The partial disinhibiting and other effects do not explain the therapeutic reorganization which takes place in the whole personality. From the psychopharmacodynamic point of view, two groups of effects can be distinguished: a) direct activating or inactivating effects upon the basic functions (endothymic-vital level) and b)mediated and indirect effects upon the superstructures of the personality. Effects of this sort on the structure of paranoid have been described as a global ‘organizing’ action. Analysis shows that they are acting upon the different functional systems of the personality,centred on the proprium or self, in its relations with the self, with others and with the world which have undergone paranoid alteration. These effects differ qualitatively from a simple neuroleptic effect. This psychopharmacodynamic perspective enables us to integrate and to understand the complementary action of sociotherapy and psychotherapy, combined with drug therapy (pharmacopsychotherapy). The consequences of systematic clinical analysis and the development of therapy for our knowledge of pathogenic conditions and the structure of the paranoid syndrome are discussed.

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