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Part Two: The Rio de Janeiro Unit: Controversies

TOWARDS EDUCATION IN THE HISTORY OF NEUROPSYCHOPHARMACOLOGY

Part 2 - The Rio de Janeiro Unit: Controversies - Thomas A. Ban

Neuropsychopharmacology, a composite discipline of psychopharmacology and neuropharmacology, studies the relationship between neuronal and mental events with the use of centrally acting drugs (Ban 2011). Its birth, in the mid-20th century, was intimately linked to the introduction of the first set of therapeutically effective drugs in the treatment of functional psychiatric disorders and the spectrophotofluorometer; and its development, during the past 70 years, has been driven by psychotropic drug development. Neuropsychopharmacology has evolved through “controversies” and decisions in these controversies profoundly affected the development of the field.

Since the time the International Network for History of Neuropsychopharmacology (INHN) was founded in 2013, 11 controversies in the history of the field were posted on the website of the Network, in the form of essays. In chronology of posting they are:

1.      The Q-T interval and the Mellaril story: A cautionary tale, presented by Edward Shorter, on July 18, 2013.

2.      Addictions are not treatable diseases, presented by Paul Devenyi, on September 12, 2013.

3.      Pharmacotherapy of addiction: not a success story, presented by Paul Devenyi, on December 5, 2013.

4.      Conflict of interest in neuropsychopharmacology: marketing versus education, presented by Thomas A. Ban, on  December 26, 2013.

5.      Onset of clinical action of antidepressants, presented by Martin M. Katz, on January 9, 2014.

6.       Component-specific versus diagnosis-specific clinical trial in depression, presented by Martin M. Katz, on February 27, 2014.

7.      Multivantaged versus conventional assessment method, presented by Martin M. Katz, on May 22, 2014.

8.      The lithium controversy: A historical autopsy, presented by Barry Blackwell, on June 19, 2014.

9.      The trazodone controversy and its potential fatal consequences, presented by Samuel Gershon, on July 31, 2014.

10.  The anxiety enigma, presented by Barry Blackwell, on October 3, 2014.

11.   Adumbration: A history lesson, presented by Barry Blackwell, on December 18, 2014.

From the 11 essays, five (1, 2, 4, and 5) triggered interaction in the form of comments, replies to comments and response to replies.

Rapid progress in neuropharmacology from the 1950s to the 1990s raised high expectations for discovering relationships between neuronal and mental events and developing selective drugs for the treatment of mental disorders. Neither of these expectations was fulfilled. By the end of the 20th century, it became evident that in spite of the introduction of numerous compounds with different chemical structures and pharmacological profiles into each class of psychotropic drugs, the changes in the chemical structure and pharmacological profile of the new drugs translated only into differential adverse effects. The lack of progress in the pharmacological treatment of functional psychiatric disorders coupled with the lack of progress about information on the neuronal underpinning of mental disorders indicates that it is very likely that in the majority of controversies which impacted on the development of the field, the wrong decisions were taken.

To stimulate the generation of new controversy essays, facilitate interaction about these essays and coordinate activities in the “controversies” project, a special unit was established in Rio de Janeiro, Brazil. The primary objective of this Unit is to identify, in collaboration with members of the Network, the controversies, in which the decisions taken had a major impact on the development of the field; develop a chronological list of these controversies; and generate interaction about each of these controversies.

 

References:

Ban TA. Preface. In Gershon S (volume editor). Neuropsychopharmacology. In Ban TA (series editor). An Oral History of Neuropsychopharmacology. Volume 5. Brentwood: American College of Neuropsychopharmacology; 2011, pp. IX-XXX.

 

Thomas A. Ban

April 16, 2015