Thomas A. Ban
Neuropsychopharmacology in Historical Perspective
Education in the Field in the Post-Neuropsychopharmacology Era
Fifty years ACNP
(Bulletin 32)

Preamble

“Fifty Years ACNP”is based on the Preface to Volume 10 of the series “An Oral History of Neuropsychopharmacology, The First Fifty Years, Peer Interviews,” edited by Thomas A. Ban. The series was published by the American College of Neuropsychopharmacology (ACNP) in Brentwood, Tennessee, in 2011, pp. IX – XIX.

Fifty Years ACNP

Developments which led to the birth of ACNP began in the mid-1950s with the recognition that progress in neuropsychopharmacology depends on a continuous dialogue between clinicians and basic scientists.  To start the dialogue, Silvio Garattini, a young pharmacologist in the Department of Pharmacology of the University of Milan, organized the first international symposium on Psychotropic Drugs in May 1957 in Milan (Garattini and Valzelli 1957).During this symposium - chaired by Emilio Trabucchi, the head of the Department - a special meeting was convened at which Wolfgang de Boor, a German psychiatrist who in 1956 authored a monograph on Pharmacopsychology and Psychopathology, and Corneille Radouco-Thomas, a Romanian born pharmacologist working in Switzerland, proposed the founding of an “international association” that was to become the Collegium Internationale Neuro-Psychopharmacologicum (CINP) (de Boor 1956; Radouco-Thomas 1992).

CINP, the first neuropsychopharmacology organization, was inaugurated during the Second World Congress of Psychiatry in Zurich, on September 2, 1957, at a dinner meeting hosted by Ernst Rothlin. Rothlin, a former director of Sandoz, a major Swiss pharmaceutical company at the time, was elected president and his 32 invited guests, including four Americans - Henry Brill, Bernard Brodie, Herman C.B. Denber and Nathan S. Kline - became the founders of CINP (Ban 2006; Ban and Hippius 1992; Ban and Ray 1996).Two years later in 1959, two other neuropsychopharmacology organizations were founded: the Scandinavian College of Neuropsychopharmacology and the Czechoslovakian Psychopharmacology Society(Ban, Healy and Shorter 2004; Vinar 2004).The American College, chronologically the fourth organization founded, was born in 1961.

By the time of the founding of ACNP, American behavioral pharmacological research was intensively involved in the pharmacological screening for psychotropic drugs:Bernard Brodie and his school reported on the first correlations between biochemical changes in the brain and behavioral effects and Jonathan Cole’s early clinical drug evaluation unit (ECDEU) network was ready to begin exploring the therapeutic effects of a rapidly growing number of new substances in different mental disorders. While pharmacologists instantly recognized the perspective opened by the introduction of psychotropic drugs for the study of the relationship between neuronal and mental events, academic psychiatry, dominated by a psychoanalytic establishment, resisted to accept even the obviously effective new treatments(Ban 2004).

The chain of events which culminated in the founding of ACNP began with the organization of a “Conference for the Advancement of Neuropsychopharmacology” by Theodore Rothman, a psychiatrist and psychoanalyst from Los Angeles. with 38 participants. The conference, supported by the US branch of Geigy, a Swiss pharmaceutical company, took place in New York at the Barbizon Plaza Hotel, on November 12-13, 1960. It was chaired by Paul Hoch, theCommissioner of the State of New York Department of Mental Hygiene, who was President of CINP at the time. During this conference Rothman proposed the founding of an American association of neuropsychopharmacology that would be an affiliate of the international college which, by that time, held two congresses, one in Rome and another in Basle. After discussing the pros and cons of being an affiliate of CINP or an independent organization, Hoch put forward the motion to establish an organization of neuropsychopharmacology that is a “purely American affair.” It was carried by 37 votes for and one against.

            After the vote Frank Ayd, a psychiatrist from Baltimore, put forward the motion: “That this organization, make an effort to become affiliated with the International Collegium and that the final decision would be left at the discretion of the officers of this organization when they are duly constituted.” The motion was seconded by Douglas Goldman, a psychiatrist from Cincinnati, and carried by 37 votes.

            Finally, Sidney Malitz, a psychiatrist and at the time senior research scientist at the New York Psychiatric Institute, put forward the motion that an organizing committee be formed with Theodore Rothman as chairman;Paul Hoch, Frank Ayd, Jonathan Cole and Paul Feldman (a psychiatrist and psychoanalyst from New York) as members;and with Bernard Brodie as basic science consultant. The motion was seconded by Wilfred Dorfman, President Academy of Psychosomatic Medicine at the time, and carried with 37 votes (Ray 1997).  

            In the 11 months that followed, the Organizing Committee devoted itself to “inquiring, studying and readying plans for an organizational meeting of interested individuals drawn from neuropsychopharmacology with the set purpose of creating a permanent Society for the Advancement of Neuropsychopharmacology.” They debated issues such as the name of the organization, the nature of the organization and criteria of membership. The Committee prepared a draft Constitution and By-Laws and delegated Frank Ayd to take the necessary steps to form a non-profit, scientific research corporation in the State of Maryland (Ayd 1986).

The First Organizational Meeting of the association was held at the Woodner Hotel in Washington, D.C., on October 7-8, 1961, with participants from 22 states and two Canadian provinces, representing psychiatry, pharmacology, neurophysiology, psychology and biochemistry (Ray 2004). The 104 participants of this meeting became the Founders of ACNP. Founders approved the name “American College of Neuropsychopharmacology” for the society, suggested by Joel Elkes, and agreed that the term “American” in the name should imply North America and not just the United States. The Constitution and By Laws, drafted by the organizers, was also approved. Membership was limited to “experienced investigators whose work is considered of merit” and duration of presidency restricted to one year. Joel Elkes was elected as the first president with Paul Hoch as president-elect; Klaus Unna vice-president; Theodore Rothman secretary–treasurer; Milton Greenblatt assistant secretary-treasurer; and Frank Ayd, Bernard Brodie, Jonathan Cole, Heinz Lehmann, Joseph Toman and Joseph Zubin as councilors. The Councilwas mandated to structure the work of the college through committees. Then, to begin operations, nine  constitutional committees were established: Credentials, chaired by Fritz Freyhan;Nominating, chaired by Max Rinkel;Finance and Budget, chaired by Paul Hoch;Program and Scientific Communication, chaired by Jonathan O. Cole;Publication, chaired by Theodore Rothman;Liaison with Learned Societies, chaired by Ralph Gerard;Ethical Matters, chaired by Nolan Lewis;Education and Training, chaired by Klaus Unna;and Liaison with Governmental Agencies and Industry, chaired by Henry Brill(Ayd 1986).

To ensure that the membership of the new association would remain restricted to those actively involved in research, it was decided that “new” members should be elected by the nomination of two “old” members of the College (Ray 2014).Initially, ACNP consisted of 123 charter fellows whose credentials were vetted by Freyhan; in 1965 it was extended to a maximum of 160 members/fellows. This upper limit was strictly adhered to anda qualified candidate could only be elected to membership if an “old” member died or moved into emeritus status. As time passed, this severe restriction on membership was lifted toallow an increase in the total number, first by no more than 10, then no more than 15and ultimately in 1994, no more than 20 new members a year (Ayd 1986; Ray 2004). In spite of all restrictions, membership steadily grew and broadened to include researchers from psychiatric epidemiology to molecular genetics. Based on a count made onJune 29, 2010, total ACNP membershipwas 930 and included: 445 members (46 emeritus inclusive);265 fellows, i.e., members eligible to hold office (62 emeritus inclusive);81 associate members;75 life fellows (48 emeritus inclusive);49 foreign corresponding fellows (19 emeritus inclusive);nineadministrative members;fouremeritus life members; and twohonorary fellows (oneemeritus inclusive).  Throughout the years more individuals were nominated to membership than slots to be filled, but only rarely have all the slots filled (Ray 2004).

Atthe center of ACNP’s activities is the annual meeting which provides a platform for interaction between clinical and basic researchers in ascientific program. The site of these meetings is selected to provide a suitable environment for informal interaction between academia, industry and government. The first three annual meetings of the organization (1962, 1963 and1964) were held in Washington, D.C. The primary site of the meeting was then moved to San Juan,Puerto Rico.  From 1965 to 1996, of every four meetings, three were held in San Juan and one in the US, e.g., Washington, D.C., San Diego,Palm Springs and Las Vegas. Subsequently, annual meetings were held in Arizona, Florida, Hawaii, Mexico and also in Puerto Rico. The meetings are usually scheduled for mid-December.

ACNP’s annual meetings are “closed” ˗ restricted to members and their invited (one) guest. One of the important features of the meetings is the discussion held in the Study Groups, initiated by Joel Elkes, with the participation of members engaged in different areas of research (Ayd 1986; Wittenborn 1997).For many years, annual meetings were opened with a half-day plenary session followed by study groups, panel sessions and poster sessions, with a business meeting on the third day. In 1975 the opening plenary session became the “President’s Plenary,” followed, beginning in1996, by a “Distinguished Lecture” before regular activities began. In 1991 a “Teaching Day”was introduced and scheduled for Sunday,the day before the President’s Plenary officially opened the meeting. As time passed the program of annual meetings came to accommodate a variety of activities:in 1993 an ACNP-Corporate Panel was introduced; in 1994 a plenary on current topics; in 1996 a legislative workshop; in 2002 a memorial symposium and a history lecture.The College also established several awards, presented at the business meeting, and included: the Paul Hoch Distinguished Service Award, first presented to Jonathan O. Cole in 1965; the Daniel H. Efron Research Award, first presented to Solomon H. Snyder in 1974; the Joel Elkes Research Award, first presented to Kenneth L. Davis in 1986; the ACNP Media Award, first presented to Ellen Levine (Chief, Good Housekeeping Magazine) in 2002; and the Julius Axelrod Mentorship Award, first presented to George Heninger in 2004.  In 1980 Mead Johnson, an American drug company, established “Travel Awards for Young Investigators” to assist their attendance at annual meetings. Other drug companies followed suit, like Marion Merrell Dow in 1991. In 1990 “Minority Travel Awards” and the “Upjohn Summer Fellowship Award Program” were introduced; in 1996 the “Glaxo Wellcome Fellowship in Clinical Neuropsychopharmacology”;and in 1997 the Council approved the establishment of the “ACNP Memorial Travel Awards.”In 2010 there were Memorial Travel Awards in the names of Louis Lasagna, Marion WeinbaumFischman, Arnold Friedhoff, Leo E. Hollister, Seymour S. Kety, Heinz E. Lehmann, Jerry Sepinwall, Menek Goldstein, Daniel X. Freedman and Gerald Klerman.  Furthermore, in 1991 a “Mentorship Program” was introduced for Travel Awardees at the annual meetings (American College of Neuropsychopharmacology 2010; Ray 1997).

At the time ACNP had its first annual meeting in 1962, the US Congress passed the Kefauver-Harris Amendment to the Food and Drug Act which mandated proof of efficacy, in addition to safety, for marketing approval for a new drug. There was a need for guidance concerning clinical methodologies and developing standards of drug efficacy. The information in Psychopharmacology Problems in Evaluation, a volume based on the proceedings of a conference sponsored by the National Institute of Mental Health (NIMH), the National Academy of Sciences-National Research Council in 1956, no longer sufficed (Cole and Gerard 1959).To address this issue, ACNP’s Liaison Committee with Government and Industry developed, in 1969, a collaborative effort with NIMH. It led,in 1971,to the publication of Principles and Problems in Establishing Efficacy of Psychotropic Drugs, edited by Jerome Levine, Burtrum Schiele and Lorraine Bouthilet(Levine, Schiele and Bouthilet 1971; Robinson 1997).In addition, after discussions with the FDA and the Pharmaceutical Manufacturers Association, the ACNP signed a contract with the FDA in 1972 to develop guidelines for clinical investigations with psychotropic drugs. The Task Force was chaired by Richard Wittenborn, with Gerald Klerman and E. H.  Uhlenhuth guiding the groups working on guidelines for clinical investigations with drugs in the treatment of depressive and anxiety disorders, respectively (Wittenborn 1997). In the years that followed, regulation for drug approval, as well as the methodology of clinical investigations, was further refined and another collaborative effort between ACNP and NIMH was undertaken. It led to the publication of Clinical Evaluation of Psychotropic Drugs: Principles and Guidelines, edited by Robert F. Prien and Donald S. Robinson in 1994 (Prien and Robinson 1994; Robinson 1997) .

In the first two decades of ACNP’s operation (1960s and ‘70s) educational material in neuropsychopharmacology was still scarce and communication of information slow.  To create educational material the ACNP was encouraged to publish the proceedings of some of its annual meeting symposia; moreover, to that end, special symposia between meetings were to generate additional material. The first two books which appeared under the imprimatur of the College werePrediction of Response to Pharmacotherapy, edited by Richard Wittenborn and Philip May, and Pharmacotherapy of Depression, edited by Jonathan Cole and Richard Wittenborn (Cole 1966; Wittenborn and May 1966).These were followed by Drug Abuse, edited by Cole and Wittenborn and published in 1969 (Cole and Wittenborn 1969). From 1971 to 1980 there were nine publications under the imprimatur of ACNP:in 1971The Psychopharmacology of the Normal Human, edited by Wayne Evans and Nathan Kline;Psychotropic Drugs in the Year 2000,edited also by Wayne Evans and Nathan Kline;and Scientific Models and Psychopathology,edited by Seymour Fisher, were published; in 1972, L-Dopa and Behavior, edited by Sidney Malitz; in 1973, Opiate Addiction: Origins and Treatment, edited by Seymour Fisher and Alfred Freedman;  in 1975, Neurotransmitter Balance Regulating Behavior, edited  by Edward Domino and John Davis; in 1976, Pharmacokinetics of Psychoactive Drugs: Blood Levels and Clinical Response,edited by Louis Gottschalk and Sidney Merlis; in 1978, Legal and Ethical Issues in Human Research and Treatment: Psychopharmacologic Considerations, edited by Donald Gallant and Robert Force; in 1979, Pharmacokinetics of Psychoactive Drugs: Further Studies, edited by Louis Gottschalk; and in 1980,  TardiveDyskinesia: Research and Treatment, edited by Edward Fann, Robert Smith, John Davis and Edward Domino (Davis, Domino and Davis 1975; Evans and Kline 1971aand b; Fann, Smith, Davis and  Domino1980; Fisher 1971; Fisher and Freedman 1973; Gallant and Force 1978; Gottschalk 1979; Gottschalk and Merlis 1976; Malitz  1972).

ACNP’s educational activities received strong impetus in 1984 from the development of a “Model Psychopharmacology Curriculum." A lecture series in clinical psychopharmacology was initiated in 1993 and regional meetings on practical clinical psychopharmacology began in 1994 (Efron 1968).

In 1968the proceedings of the Sixth Annual Meeting (San Juan, Puerto Rico, from September 12 to 15, 1967), edited by Daniel Efron - and co-edited by Jonathan Cole, Jerome Levine and Richard Wittenborn -  were published under the title, Psychopharmacology A Review of Progress 1957-1967(Efron 1968).Its success stimulated interest in similar publications reviewing the development of the field. The series, called the “Generation of Progress,” includes:Psychopharmacology: A Generation of Progress, co-edited by Morris Lipton, AlbertoDiMascio and Keith Killam,  published in 1978; The Third Generation of Progress, edited by Herbert Meltzer, published in 1987; The Fourth Generation of Progress, co-edited by David Kupfer  and Floyd Bloom,  published in 1995; and The Fifth Generation of Progress, co-edited by Kenneth Davis, Dennis Charney, Joseph Coyle and Charles Nemeroff, published in 2002 (Davis, Charney, Coyle and Nemeroff 2002; Kupfer and Bloom 1995; Lipton, DiMascio and Killam Meltzer 1978; Meltzer 1987). The Fifth Generation of Progress was the first volume published simultaneously in print and electronic format.

After the publication of the fifth volume, “Generation of Progress” was replaced with Neuropsychopharmacology Reviews, an annual collection of review articles, published each January in the first issue of Neuropsychopharmacology. The inaugural issue of the new series was edited by Peter Kalivas and Husseini Manji in 2008 (Enna 2008).

Neuropsychopharmacology, ACNP’s journal, was launched in December 1987, with Christian Gillin as the first editor. In 1994 the editorial tasks were passed to Herbert Meltzer (clinical) and Roland Ciaranello (basic); when Ciaranello died (in the same year) his position was filled by H.Christian Fibiger (Ray 2014). In 1998 the dual editorship was replaced by the appointment of a single editor, Robert Lenox. He was succeeded in 2002 by Charles Nemeroff, who served through December 2006. In 2007, James H. Meador-Woodruff was appointed editor, with Ariel Deutsch and Stephen R. Marder as deputy editors.

By the 1990s the pioneering generation was fading away and with the death of each pioneer a piece in the history of the field was lost. To prevent the silent erosion of this history in 1993, on the initiative of Oakley Ray, at the time Secretary of ACNP, a project of videotaping interviews with elders of neuropsychopharmacology began. It was complemented in 1995 with the creation of a History Task Force and in 1996 with the establishment of the ACNP-Solvay International Archives in Neuropsychopharmacology at Vanderbilt University Medical Center, Nashville, Tennessee (Ray1997).The videotaping of interviews has grown into the oral history project that conducted interviews primarily during the annual meetings from 1994 to 2008. The History Task Force was enlarged and converted into a constitutional committee with Thomas A. Ban as LifeMember.  The ACNP-Solvay International Archives was renamed ACNP’s International Archives in Neuropsychopharmacology after the funds received from Solvay Pharmaceuticals were depleted; in 2008 the Archives was transferred to the University of Los Angeles in California.

ACNP activities have extended over the years to an agenda based on the premise that “Scientific research is good for the country, and only through research can we ever hope to reduce the high social and economic cost of mental illness and addictive behavior” (Ray 2014).The first President of the College who actively embarked on this agenda was Donald Klein. He started a program in 1981 in which officers and council members of the College visited with policy makers at the Food and Drug Administration and senators in Washington, D.C., one to three times a year. The program continued for 13years. Then, in 1994, Thomas Detre, the 33^rd President of the College,launched another program based on a “grass roots” approach (Ray 2014).Opinions differ on whether ACNP has ever lobbied,but since the time of its inception in one or another way the organization has always fought for adequate funding of research (Ray 2014).

Availability of grant support is an essential prerequisite for the research of ACNP’s membership. Stephen Koslow, a fellow of ACNP,suggested that changes in NIMH’s funding priorities in the early 1980s played a role in the shift of focus from clinical to basic research in the programs of annual meetings. By the 1980s the excitement at early meetings about developing a clinical methodology to translate the mode of action of psychotropic drugs in the brain was gone. It was replaced by fascination about the detection of changes affected in signal transduction and molecular genetic mechanisms by centrally acting drugs. To communicate findings about the clinical use of new psychotropic drugs, in 1992 two ACNP fellows, Paul Wender and Donald Klein, spearheaded the founding of the “American Society of Clinical Psychopharmacology.”

 To facilitate these expanding activities several new constitutional committees were established and include: the Committee on Relationships with Advocacy Groups, the Committee on the Use of Animals in Neuropsychopharmacology, the Honorific Awards Committee, the Constitution and Rules Committee, the History Committee and the Human Research Committee (American College of Neuropsychopharmacology 2010).All but one of the original committees, the Committee for Liaison with Learned Societies, continue.

In 1984 the College officially recognized and began to correspond with neuropsychopharmacology organizations outside the United States. In 1989 it invited members of the European College of Neuropsychopharmacology (ECNP) and in 1990 members of the Canadian College of Neuropsychopharmacology (CCNP) were invited to attend its annual meetings.  It also introduced a Symposium Exchange Program with ECNP in 1989 (Ray 1997).

ACNP has never affiliated with CINP, as some of the prospective founders of the College proposed, but the annual meeting in 1966 included a joint plenary session and a colloquium that involved both ACNP and CINP members. Furthermore, five of ACNP’s presidents (Paul Hoch, Heinz Lehmann, Leo Hollister, William Bunney, Jr. and Herbert Meltzer), served also as presidents of CINP, and about one-third of CINP members are ACNP members.

In 1964, Richard Wittenborn, ACNP’s Secretary/Treasurer at the time, estimated that to cover the expense of expanding activities the College needed around $20,000 per year. Since the available sources for supplementing income were industry or government, concerns were raised that reliance heavily on one source could give an impression that the policy or recommendations of the College reflected the influence of that primary source (Wittenborn 1997).To overcome the difficulties in cash flow, it was suggested that the 10pharmaceutical houses paying annual corporate membership at the time provide a one-time contribution of $10,000. The idea was to create an interest-bearing endowment fund of $100,000 that would supplement other sources of income sufficiently to assure that the College could continue with its operations uncompromised.  The recommendation was accepted but only one company, Sandoz, was willing to subscribe tothe endowment fund. The only other contribution towards this endowment fund was a $25,000 donation from Jack Dreyfus of the Camille and Henry Dreyfus Foundation, on the encouragement of William Turner, in recognition of the value of the College “as a forum in which untested issues might be explored and illuminating investigations might be instigated”(Turner 2011).Nevertheless, the College survived and during the years the number of supporting corporations grew from 10 in 1965 to 20 in 2010. The organization which in the 1960s struggled establishing a $100,000 endowment fund, operatedin 2010with an annual budgeted income of more than $3million against a more than $2.5million budgeted expense.  In 2010 27% of the revenue that supportedACNP operations came from the drug industry and another 13% of its total revenue came from grants from the drug industry supporting specific programs, such as travel awards for young scientists, the annual meeting and other special projects. 

ACNP’s chief executive officer is the President, who is also the chairperson of the Council. However, since the President is elected for a term of one year and is not eligible for re-election to that office, it isthe Secretary/Treasurer (later Secretary and Treasurer), elected for five years with possible re-election for another five years, who provided for the continuity of operations.From 1962 to 1999 the secretary/treasurer position was held by Rothman 1962-1964; Wittenborn 1965-1971; DiMascio 1972-1978; and Oakley Ray 1980-1999. During Ray’s tenure ACNP entered the electronic age by acquiring ane-mail address in 1995, establishing aHome Page on Worldwide Web in 1996 and appointing James Meador-Woodruff as its scientific website editor in 1999.

In 1999 the administration of ACNP was consolidated with the appointment of Ronnie Wilkins, EdD,as Executive Director. Wilkins relieved the Secretary from attending ACNP’s day-to-day business, including supervision of staff, coordination of activities and organization of meetings. He converted the central office into an executive office and in 2010 moved it onto the organization’s property in Brentwood, Tennessee

In November 2011, during Wilkins tenure, ACNP celebrated its 50th  anniversary at its annual meeting. It was during this meeting that the interviewscollected in the “oral history project,”converted into a 10-volumes series, edited by Thomas A. Ban with a nine- member editorial team, were presented. The editorial team included: Barry Blackwell, Max Fink, Samuel Gershon, Jerome Levine, Martin Katz, Herbert Kleber, Carl Salzman, EdwardShorter and Fridolin Sulser (Ban 2011; Blackwell 2011a, b; Fink 2011; Gershon 2011; Levine 2011;Katz 2011; Kleber 2011; Salzman 2011; Shorter 2011; Sulser 2011). 

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August 23, 2018