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Typical Antipsychotic


Marketed under the trade name Thorazine by Smith-Kline & French, chlorpromazine received Food & Drug Administration approval for psychiatric treatment in 1954. Recognized as the first antipsychotic drug, chlorpromazine played a prominent role in the deinstitutionalization movement--a federal policy responsible for the release of thousands of mentally ill patients from U.S. asylums during the 1960s and 1970s.

Chlorpromazine's origins are found in a series of phenothiazine amines noted for their antihistaminic properties. Researchers discovered that one of the most potent phenothiazine amines, promethazine--synthesized in France in the 1940s by the pharmaceutical firm Rhône-Poulenc--had major central nervous system side effects. Out of this discovery, Rhône-Poulenc researchers synthesized chlorpromazine, which not only had antihistamine and antiemetic properties but also made the effects of barbiturates more powerful.

 HALLUCINATIONS More than 2 million Americans per year suffer from schizophrenia--a chronic and severe brain disease. LOUISE WILLIAMS/SCIENCE PHOTO LIBRARY

HALLUCINATIONS More than 2 million Americans per year suffer from schizophrenia--a chronic and severe brain disease.

It was the barbiturate-enhancing effect of chlorpromazine that led French naval surgeon Henri Laborit to it in 1951. Laborit was in search of a surgical anesthetic but discovered that chlorpromazine put his patients in a detached vegetative state. By 1952, Smith-Kline & French had purchased the rights to the drug from Rhône-Poulenc, and French psychiatrists Jean Delay and Pierre Deniker were touting the therapeutic effects that chlorpromazine had on schizophrenic patients.

Considering treatments for schizophrenia at the time, it is no surprise chlorpromazine was seen as a promising alternative. In the 1940s and early '50s, treatment of psychotic patients included lobotomy, electroshock, or insulin coma therapy. Intended to quell hallucinations and aggressive outbursts in patients, all three treatments were unreliable and offered irreversibly damaging side effects. The easily administered drug was a profound shift away from invasive procedures like the lobotomy.

After its introduction in the U.S. in 1954, chlorpromazine quickly rose to become a staple of asylum medicine. Cash-strapped and overcrowded state hospitals flocked to the cost-effective treatment, but it would not take long for chlorpromazine to extend beyond asylum medicine and be used as a treatment to return mental patients to society.

Likened to prisons and seen as a financial burden, state hospitals had fallen out of favor in the U.S.; small community care centers were viewed as the future of mental health care. With reports of chlorpromazine sending schizophrenic hallucinations and delusions into remission, the drug was no