Terra incognita : an historiographic approach to the first chlorpromazine trials using patient records of the Psychiatric University Clinic in Heidelberg

Abstract

Psychiatrists have often referred to the discovery of new psychopharmaceutical drugs in the 1950s as a 'therapeutic revolution', which allowed physicians to observe und measure therapeutic effectiveness easily. Contrary to this view, this article will argue that psychiatrists needed the patient's subjective voice to evaluate the effects of the drugs. In a micro-analysis of hospital records of the first patient to be treated with chlorpromazine in the Heidelberg clinic in 1953, I show the different perspectives of doctors and patients on the diagnosis and treatment.The analysis points up how difficult it was to get an impression of the drug's effectiveness.The article emphasizes the importance of the new perspective that includes the patient's voice in the history of psychotropic drugs after 1945.

Performing doubt and negotiating uncertainty

“…Influenced by new perspectives in social history and science studies and relying on new sources such as medical records, this scholarship has focused on the ways in which diagnostic concepts were constantly regenerated in the daily work of the clinics (Bernet, 2013; Herrn and Friedland, 2014; Ledebur, 2015). It has insisted on the multiple meanings diagnosis has had for the various participants in psychiatric work as well as on its situated dimensions (Balz, 2011; Braslow, 1997; Majerus, 2013). It has highlighted the role of ‘paper technologies’ in shaping psychiatric thought as well as in the patient’s perspectives (Balz, 2010; Borck and Schäfer, 2015; Hess and Mendelsohn, 2014; Ledebur, 2015).…”

The Silo Effect in Research on PTSD

“…6 Then came the advent of pharmacotherapy for depression with the introduction of imipramine 7 and for schizophrenia with the introduction of chlorpromazine. 8 Over the next 25 years, many new drugs were introduced for the treatment of depression and schizophrenia. Typically the medications for depression were tricyclic compounds similar to imipramine, while the treatments for schizophrenia were primarily phenothiazines.…”