A Science Odyssey
People and Discoveries

Drug for treating schizophrenia identified

In 1952, Henri Laborit, a surgeon in Paris, was looking for a way to reduce surgical shock in his patients. Much of the shock came from the anaesthesia, and if he could find a way to use less, his patients could recover quicker. He knew that shock was the result of certain brain chemicals and looked for a chemical that might counteract these. He tried antihistamines, usually used to fight allergies.

He noticed when he gave a strong dose to his patients, their mental state changed. They didn't seem anxious about their upcoming surgery, in fact, they were rather indifferent. Laborit was able to operate using much less anaesthetic. He was so struck by the effect on his patients, especially with a drug called chlorpromazine (trade name Thorazine) he thought the drug must have some use in psychiatry. But at that time, "no one in his right mind in psychiatry was working with drugs. You used shock or various psychotherapies," said Canadian psychiatrist Heinz Lehmann. Laborit kept pressing his point, however. A fellow surgeon passed the word to his brother-in-law, the psychiatrist Pierre Deniker. Deniker's interest was piqued and he ordered some chlorpromazine to try on his most agitated, uncontrollable patients.

The results were stunning. Patients who had stood in one spot without moving for weeks, patients who had to be restrained because of violent behavior, could now make contact with others and be left without supervision. Another psychiatrist reported, "For the first time we could see that they were sick individuals to whom we could now talk."

Severe mental illness had been increasing since the beginning of the century. In 1904, two Americans in a thousand were in mental hospitals; by 1955, four in a thousand were institutionalized. Psychiatrists argued whether it was a result of biology or of experience, but there was nothing to help the chronically mentally ill. They were usually warehoused in state institutions.

Meanwhile, the American drug company Smith Kline was trying to expand its product line. It had a little money for research and was looking for promising leads. Smith Kline purchased the rights to chlorpromazine from the European company Rhône-Poulenc in 1952. Smith Kline put it on the market as an anti-vomiting treatment. But word of the French psychiatrists' success with it had spread. Smith Kline tried to convince American university psychology departments and medical schools to test the drug, but the academics saw it as just another sedative and were more intersted in psychoanalysis and behaviorism. Smith Kline invited Pierre Deniker to help them convince U.S. practitioners to try the drug. Their success came by way of the state institutions. They told state governments they had a way to save them money. Testing was begun at these institutions, where the most hopeless cases were housed. The results were convincing, even miraculous. They were reported on television and in the news.

In 1954 chlorpromazine was approved by the U.S. Food and Drug Administration, and it took the country by storm. It had a calming effect without sedating patients, allowing them to live a nearly normal life. By 1964, some 50 million people around the world had taken the drug. And Smith Kline revenues doubled three times in 15 years.

There were side effects and drawbacks to the drug which were revealed in the passing years. But the dramatic effect of a chemical on the brain had wider repercussions. For example, one side effect of the drug made people appear to have Parkinson's. This opened the question: maybe similar chemicals are involved in natural Parkinson's disease and thus can be counteracted. Correlations like this led the way to an understanding of the role of dopamine and other neurotransmitters in brain function and behavior.

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