1952

Paris military surgeon Laborit publishes first article on chlorpromazine’s usefulness in surgery (re “potentiator” of anesthesia and prevention of postsurgical shock), rendering patients calm, relaxed, and detached; they used it as part of a “lytic cocktail” designed to reduce surgical stress in multiple body systems (Healy, II, 79-80). Drug was synthesized by Paul Charpentier of Rhone-Poulenc as RP4360, on December 11, 1950. It was a chlorinated form of the antihistamine Promazine, sold as Sparine (Healy, II, 81). Laborit encouraged J. Hamon to try it on psychiatric patients at Val de Grace Hospital in February; then French psychiatrists Jean Delay and Pierre Deniker at Hopital Ste-Anne published six papers between May and July describing psychiatric trials with chlorpromazine (Healy, II, 85-93; López-Munoz II). They referred to the clinical picture of slowing down of motor activity, affective indifference and emotional neutrality as neuroleptic syndrome (neuroleptic from the Greek “that take the nerve”). Drug firm Rhone-Poulenc began making it available for clinical trials, exploring various applications as an anesthetic, to induce “hibernation” during surgery; as an antiemetic for seasickness; a treatment for burns, stress, infections, obesity, Parkinson’s disease, epilepsy. By 1953, following reports of Delay and Deniker (Paris), Heinz Lehmann (Montreal), and Winkelman (Phila), clinical trials centered on psychiatric applications (Valenstein, 24-25; Healy, I, 43-48). Smith Kline & French acquired U.S. rights to the drug, which it initially hoped to market to surgeons and psychiatrists; it licensed chlorpromazine as an anti-emetic, not as an antipsychotic (Healy, II, 84-85). But by end of 1953, it was concentrating on marketing chlorpromazine in psychiatry, naming it Thorazine in May, 1954 (Valenstein, 30-31; on marketing of Thorazine by SK&F, 167-69). Healy (II, 97) says that when SK&F finally launched Thorazine in 1955 (Valenstein puts launch at end of 1953), even though the license application had been for an anti-emetic, “the take-up in psychiatry was astonishing – SK&F reportedly took in $75 million the first year the drug was sold.” Release of Miltown in second half of 1955 popularized the term “tranquilizer” (coined by Ciba’s F F. Yonkman in 1953 to describe reserpine) and led to Thorazine’s designation as a “major tranquilizer” whereas Miltown and later Librium and Valium were “minor tranquilizers” (Healy, II, 99).