Chlorpromazine: a remedy of its time

Abstract

In order to historically validate the widely accepted argument that the cornerstone of contemporary psychiatry’s biological conceptual structure was the introduction of chlorpromazine to the treatment of mental illness in 1952, one has to adopt a historiographical model allowing a narrative of a fortuitous, or serendipitous, discovery, without any previous theoretical assumptions, that ends up provoking a chain of events that shapes a sort of scientific revolution in psychiatry in the second half of 20th century. However, if one is to consider, as we do in this study, the direct analysis of historical documentation, then the aforementioned narrative will no longer be even possible, since the documents — the first published scientific articles on chlorpromazine — not only make solid references to the theoretical conceptions that led the authors to chlorpromazine, but also do locate this theory in a specific line of research. This line is related to shock therapies, the methods of unprecedented effectiveness that were celebrated as the major theme of the First International Congress of Psychiatry, held in Paris in 1950, which guaranteed the institutionalization of the specialty through the creation of its world association of professionals, thanks to the political, corporate and scientific articulation devised by illustrious psychiatrist Jean Delay (1907-1987). The young and restless professor of the chair of mental medicine at the University of Paris was adept of synthetic, holistic, perspectives of thought, still frequent in that historical context, which allowed him to advocate for the unification of psychiatry around the results of shock treatments, as well as to predict, from the same rationale, that analogous effects could be obtained with chlorpromazine, given its tropism for certain regions of the nervous system. In addition to a historical narrative covering all mentioned events, our study seeks to outline a map of the scope and internal coherence of the theories that introduced chlorpromazine, a cartography that places it at the centre of a conceptual network that includes several authors, among them Henri Laborit, Hans Selye, Walter Cannon, Philip Bard, René Leriche, James Reilly, Harold Wolff, Henri Claude, Ladislas von Meduna, Ugo Cerletti, Manfred Sakel, Antonio Egas-Moniz, Julius Wagner-Jauregg, Kurt Goldstein, Charles Sherrington, John Hughlings Jackson, and several others. Seeking to establish criteria regarding the divergence found with the predominant historiographical model, we conclude that chlorpromazine was an authentic product of the scientific postulates of the medical theories widely referenced during the first half of the twentieth century, the same ones that conceived it as a remedy of its time. 1 jeporto1977@gmail.com