Magic Bullets: The Development of Ideas on Drug Action

Abstract

The inscription on the Lasker prize awarded to Deniker, Delay, Laborit and Lehmann in 1957 read ‘for the introduction of chlorpromazine into psychiatry and for the demonstration that a medication can influence the clinical course of the major psychoses’ (Deniker, 1989, p. 253, my emphasis). These words encapsulate the importance that was attributed to finding a physical intervention that was more than just a sticking plaster—to finding something that could change the very nature of psychiatric disorders. Although chlorpromazine and other early antipsychotics were thought to be uniquely useful, few people believed at this time, however, that they acted on the disease or abnormality that was presumed to give rise to schizophrenia or any other serious mental illness. The disease-centred view of the action of antipsychotics took a while to develop and, in the meantime, the unusual neurological effects the drugs induced were proposed to be the basis of their action, in what was essentially a drug-centred model. But, as the inscription on the Lasker award suggests, psychiatry was already aspiring towards having a drug that would modify the very nature of the problems it was confronted with.

I am indebted to other accounts that have noted how a disease-centred view of antipsychotic action emerged during the 1950s and 1960s, especially those of David Healy, Robert Whitaker and Sheldon Gelman (Gelman, 1999; Healy, 2002; Whitaker, 2002).