Abstract
The paper recalls the experiences of the author over the past forty-eight years in a field which later became known as psychopharmacology. The author began in physical chemistry and traditional pharmacology. His interest in the nervous system stemmed from X-ray diffraction studies on the structure of living myelin, and led, by way of studies on the distribution of cholinesterases and the effects of atropine, to the study of the effects of drugs on the electrical activity of the brain in the conscious animal. At the clinical level it included studies of the effects of drugs on catatonic schizophrenic stupor. These studies took place before the discovery of chlorpromazine. They led to the creation, in 1951, of the Department of Experimental Psychiatry in Birmingham, England, the first department of its kind in the world. The department included neurochemical, electrophysiological, and animal behavior laboratories and a strong clinical facility (the Uffculme Clinic). The first blind trial of chlorpromazine was carried out in that department in 1953 and 1954. The existence of families of neuroregulatory compounds, having uneven distribution in the brain, and exerting regional chemical field effects in relation to function was postulated on the basis of experimental and clinical findings. The work of colleagues and participants in the various studies is gratefully acknowledged in the text. In 1954 the author served as convening executive secretary of the first International Symposium on Neurochemistry at Oxford, England, the first meeting of its kind. He came to the United States in 1957 and founded, and served as first director of, the new Clinical Neuropharmacology Research Center, now the Center for Neuroscience at St. Elizabeth's Hospital, Washington, DC. He directed this program from 1957 to 1963. Subsequent activities at Johns Hopkins, the World Health Organization, and the International Brain Research Organization (IBRO) are recalled. In 1961 he was elected first president of the American College of Neuropsychopharmacology. In looking back, he notes the sparse and personal nature of the field in the late 1940s and early 1950s, its explosive growth in the wake of the major clinical discoveries, and above all, the emergence of a new science through the interaction of neurochemistry, electrophysiology, studies of animal behavior, and the refinement of the clinical trial. He regards the emergence of concepts of regional chemistry of the brain as particularly significant, and feels that psychopharmacology is ideally positioned to act as an intermediary between classical pharmacology and quantum biology. The transdisciplinary nature of psychopharmacology provides a template for a comprehensive psychiatry of the future–a discipline which is now positioned to lead. He also feels that future discoveries in psychopharmacology will pose a most poignant ethical dilemma for medicine, and argues for a timely readying for these responsibilities.
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Presented at the ACNP Annual Meeting, held at San Juan, Puerto Rico, December 1992.
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Elkes, J. Psychopharmacology: Finding One's Way. Neuropsychopharmacol 12, 93–111 (1995). https://doi.org/10.1016/0893-133X(93)00017-G
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DOI: https://doi.org/10.1016/0893-133X(93)00017-G
Keywords
- Psychopharmacology, history
- X-ray diffraction, myelin
- Regional neurochemistry
- Brain electrical activity in conscious animal
- Families of Neuroregulatory compounds
- Catatonic stupor
- Chlorpromazine
- Experimental psychiatry
- St. Elizabeth's
- Johns Hopkins
- American College of Neuropsychopharmacology (ACNP)
- World Health Organization (WHO)
- International Brain Research Organization (IBRO)
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