Psychopharmacology

Abstract

Research in psychopharmacology is both blessed and plagued by its history. In 1949, the psychiatrist John Cade discovered the antimanic properties of lithium when he hypothesized that manic-depressive illness is analogous to thyrotoxicosis-myxedema. Eventually, he determined that lithium made guinea pigs lethargic and manic patients calm. Within a 2-year span (1950–1951), this discovery generated three Australian and three French studies. Despite this initial enthusiasm with lithium, this event did not launch psychopharmacology as an important therapeutic field. The French surgeon Henri Laborit’s keen observation that chlorpromazine (CPZ) nullified preoperative anxiety, mitigated surgical stress, and thereby eliminated its postoperative consequences, led him with dynamic persuasion to convince early psychiatrists to give CPZ for psychotic states. Colonel Paraire, a psychiatrist and Laborit’s colleague, has been credited with the first report and publication on the therapeutic effects of intravenous (IV) CPZ in a manic patient; this article appeared in the Annales Médico-Psycholigiques in March, 1952. Delay and Deniker’s study of 38 subjects, although totally lacking in methodological rigor by modern day standards (an open study with mixed diagnoses without controls and rating scales), nevertheless, resulted in one of the notable therapeutic advances of the century, provoked research throughout the world, and stirred the ambitions of pharmaceutical manufacturers.