Chlorpromazine was first synthesized in 1944 by chemists at the Rh√¥ne-Poulenc company in France. A French naval surgeon, Henri Laborit, tested this new compound as part of a "lytic cocktail" he used to sedate patients prior to surgery, and was pleased with the results. At a 1951 meeting of the Société Belge de Chiurge, he noted that chlorpromazine could produce "a veritable medicinal lobotomy," and in a paper the following year he suggested the new drug might be of interest to psychiatry.
Two French psychiatrists, Pierre Deniker and Jean Delay, were the first to test chlorpromazine alone, rather than on combination with other drugs, and generally are credited with introducing this new drug to the modern-day psychopharmaceutical armamentarium. In a paper they described its effects: "Seated or lying down, the patient is motionless on his bed, often pale and with lowered eyelids. He remains silent most of the time. If he is questioned, he responds after a delay, slowly, in an indifferent monotone, expressing himself with few words and quickly becoming mute." Drs. Delay and Deniker noted that the effects of this drug mimicked those observed in patients with brain damage. Accordingly, they coined the term "neuroleptic, " meaning "that which seizes the neuron," to describe the drug's mode of action.
Drugs of this class are also referred to as "antipsychotics," although from the beginning it was obvious that any observed anti-psychotic effects were mere side effects of a general dulling of the patient's mental faculties. Psychiatrists Jean Sigwald and Daniel Bouttier tested chlorpromazine on a woman suffering from auditory hallucinations, and in a 1953 paper they reported she continued to hear voices but no longer attached any particular importance to them. In 1954, two British researchers reported that schizophrenic patients given the drug "continued to be subject to delusions and hallucinations, though they appeared to be less disturbed by them." That same year, Heinz Lehman, a psychiatrist at the Verdun Protestant Hospital in Montreal who pioneered the use of chlorpromazine in North America, stated "We have not observed a direct influence of the drug on delusional symptoms or hallucinatory phenomena."
“I’VE LOST SO MUCH” How Abilify became the best-selling drug in America
Part 1:
“Psychiatry has destroyed my life"
Part 2:
A medicinal lobotomy
Part 3:
“Works like a thermostat”
Part 4:
“Chemically lobotomized"
The Rhône-Poulenc company partnered with Smith Kline & French to market chlorpromazine in North America. (Smith Kline & French later merged with the Beckman company to form the SmithKline Beckman corporation, which in turn merged with the Beecham Group to form SmithKline Beecham, which in turn merged with Glaxo Wellcome to form industry giant GlaxoSmithKline.) Smith Kline & French recruited doctors Laborit and Deniker as spokesmen for the new drug. Dr. Laborit gave demonstrations at surgical centers in which he administered this drug to dogs, most of which went into fibrillation and died on the spot. Not surprisingly, the docs who viewed these presentations were unimpressed. Dr. Deniker fared better, and in 1954 Smith Kline & French began marketing chlorpromazine in North America under the brand name Thorazine.
Within less than a year over two million people had been prescribed the drug, most of them patients in state mental hospitals. In 1957, Doctors Laborit, Deniker, and Lehman were awarded the American Public Health Association's Albert Lasker Award, which has been called the "American Nobel Prize," for their role in introducing chlorpromazine into psychiatry. By 1964, officials Smith Kline & French reported that worldwide some fifty million people had been prescribed the drug. Numerous other drugs with similar modes of action were brought to market, including Haldol (haloperidol), Stelazine (trifluoperazine), Mellaril (thioridazine), Prolixin (fluphenazine), Trilafon (perphenazine), and literally scores of others.
Not everyone was so sanguine about all this. Almost from the beginning it was obvious that chlorpromazine and related drugs were causing serious, long-term damage to patients, including a disfiguring, socially-isolating disorder called "tardive dyskinesia." "Dyskinesia" means inability to control muscle movements, and "tardive" refers to the delayed onset of the condition, which may begin even after medication has been stopped. Signs include twisting of the tongue, puffing cheeks, lip smacking, sucking motions, tremors, rocking, and bizarre postures. In patients treated with neuroleptics for six months to two years, as many as 10 to 20 percent may develop tardive dyskinesia. Among elderly and long-term patients the rate may be as high as 40 percent. There is no cure.
Other patients experienced a resurgence of psychotic symptoms, which often came roaring back worse than ever ("tardive psychosis"), global mental decline ("tardive dementia"), and shrinkage of the frontal lobes of the brain. A small proportion of patients fell victim to a pernicious disorder called "neuroleptic malignant syndrome," in which the body's internal control mechanisms go haywire. This condition is characterized by fever, sweating, nausea, vomiting, rapid heartbeat, unstable blood pressure, incontinence, aphasia, stupor, muscular rigidity, tremors, and difficulty breathing, and can occur after just a single dose of neuroleptics. Mortality rates as high as 38% have been reported, although with improved recognition and management the death rate has dropped to below 10%. Survivors may be left with movement disorders, impaired speech, attention problems, difficulties comprehending commands, and persistent amnesia.
Other toxic effects of this class of drugs include sedation, headaches, dizziness, constipation, diarrhea, anxiety, sexual dysfunction, osteoporosis, blurred vision, dysphagia, dry mouth, weight gain, diabetes, and something called "rabbit syndrome."
But isn't it true that these drugs enabled hundreds of thousands of patients to be released from confinement in "snake-pit" mental hospitals and be integrated into their communities? That trope is largely a myth, as psychiatrist Peter Breggin demonstrates in his 1991 book
Toxic Psychiatry. From 1954, when Thorazine was brought to the market in the United States, to 1963, the number of patients confined to state mental hospitals barely budged. In 1963, patient numbers began to fall, but that was because "mental illness" became covered by federal disability programs. The states, acting in rational self-interest, deinstitutionalized hundreds of thousands of mental patients, some of whom went to nursing homes, while others were placed in board-and-care facilities and still others were left to their own devices. Many of those individuals ended up homeless, often cycling back and forth from hospital emergency rooms or short-term stays in psychiatric wards and then back on to the street.
In his 2010 blockbuster work of nonfiction,
Anatomy of an Epidemic, author Robert Whitaker shows, by means of official facts and figures readily available on the internet, that the proportion of Americans disabled by schizophrenia and related disorders has increased a staggering five-fold since so-called "antipsychotics" were introduced into medical practice. That makes no sense if you believe these drugs are curing mental illness. It makes perfect sense if you accept these drugs are causing mental illness.
Next: Part 3: "Works like a thermostat"
