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Hassan Azima

By Antonio E. Nardi

Hassan Azima was born in Tehran, Iran, June 28, 1922, and received his M.D.,  in 1948, from the University of Kansas in the United States. He was trained in psychiatry in Paris, France and Montreal, Canada to receive his Diploma in Psychiatry, in 1955, from McGill University. 

Azima became involved in the clinical evaluation of psychotropic drugs during his residency and, in 1954, he was among the first to publish onthe effects of chlorpromazine (CPZ) on“mental syndromes” in North America (Azima  and Ogle 1954). One year later, in 1955, he was also among the first to report on “jaundice” occurring during the administration of CPZ (Stacey, Azima, Huestis and Hoffman 1955). In the years that followed, Azima contributed to the clinical development of numerous psychotropic drugs. They included,among the neuroleptics, various phenothiazine preparations,e.g., chlorpromazine, promazine, thioridazine (Azima and Durost 1957; Azima, Durost and Arthurs 1959), Rauwolfia alkaloids (Azima, Cramer-Azima and DeVerteuil 1959), and haloperidol, a butyrophenone (Azima, Durost and Arthurs 1960); among the antidepressants, imipramine, a dibenzazepine (Azima 1959; Azima and Vispo 1958, 1959) and isocarboxazid, a hydrazine monoamine oxidase inhibitor (Azima, Durost, Arthurs and Silver 1959); and the anxiolytic meprobamate, a propanediol (Azima and Vispo 1960). 

Azima conceptualized the therapeutic action of psychotropic drugs within a psychoanalytic frame-of-reference (Azima and Sarwer-Foner  1961; Azima and Wittkower 1957). He perceived the favorable effects of neuroleptics in patients with schizophrenia, a result of replacement of “psychic defenses,” such as “withdrawal” and “splitting“ by ”movement toward external objects,” with a shift from a “schizophrenic organization,” comparable to Melanie Klein’s “paranoid position” in infantile development, to a “manic-depressive-like organization,” comparable to Klein’s (1948) “depressive position,” that replaces the “paranoid position” in infantile development (Azima , Azima and Durost 1959; Azima, Cramer-Azima and DiVerteuil 1959; Ban 1969; Klein 1948). Similarly, he perceived the favorable effects ofantidepressants in depression as a result of a shift of invested “psychic energy” from the “superego” to the “ego” and “id” (Azima 1959, 1961; Ban 1969);  and of pharmacologically-induced sleep as a result of  “ego split” with an inactivation of the “ego system”  that allows a return from “pathological fixation points” (Azima 1955; Azima and Vispo 1960).

Azima stayed at McGill, throughout his pofessional carreer. He died in Montreal, on June 26, 1962, at age 39.

Azima H. Prolonged sleep treatment in mental disorders, some  new psycopharmacological considerations. Journal of Mental Science 1955; 101: 593-603.

Azima H. Imipramine (Tofranil): a new drug  for the depressed. Canadian Medical Asociation Journal  1959; 80: 535-40.

Azima H. Psychodynamic and psychotherapeutic  problems  in connection with imipramine (Tofranil) intake. Journal of Mental Sienc 1961; 101 74-82

Azima H. Psychodynamic alterations  concomitant with Tofranil administration. Canadian Psychiatric Association Journal  1959; 4: 172-6.

Azima H, Azima FJ, Durost H. Psyhoanalytic formulations of effects of reserpine on schizophrenic organization. Archives of General Psychiatry 1959; 80: 535-40.

Azima H, Cramer-Azima FJ, DeVerteuil R. Effects of Rauwolfia derivatives on psychodynamic studies. Psychiatric Quarterly  1959; 23: 623-35.

Azima H, Durost H. Comparison of the effects of promazine and chlorpromazine in mental síndromes. Canadian Medical Association Journal 1957; 77: 671-5.

Azima H, Durost H, Arthurs D. The effet of thioridazine on mental síndromes. Comparison with chlorpromazine and promazine. Canadian Medical Association Journal  1959; 81: 549-53.

Azima H, Durost H, Arthurs D. The effect of R-1625 (haloperidol)  in mental syndromes: a multiblind study. American Journal of Psychiatry  1960; 117: 546-7.

Azima H, Durost H, Arthurs D, SilverA. The effect of R-5-0831 Marplan on depressive states. American  Journal of  Psychiatry 1959; 46: 453-4.

Azima H, Ogle W.  Effects of Largactil on mental syndromes. Canadian Medical Association Journal 1954; 71; 116-21.

Azima H, Sarwer-Foner GJ. Psychoanalytic formulations of the effect of drugs in pharmacotherapy. . In: Bordoleau J-M (ed.) Systeme  extapyramidal  et  neuroleptoques. Montreal: Ed  Psychiatriques; 1961, pp. 507-18.

Azima H, Vispo RH. Imipramine; a potent new anti-depressant compound. American Journal of Psychiatry  1958; 115: 245-6.

Azima H, Vispo RH. Efffects of imipramine (Tofranil) on depressive states. Arch Neurol Psychiat 1959;  81: 658-64.

Azima H, Vispo RH. The problema of regression during prolonged sleep treatment. In: Sarwer-Foner GJ, editor. The Dynamics of Psychiatric Drug Therapy. Springfield: Charles C. Thomas; 1960,pp. 150-62.

Azima H, Wittkower E. Anaclitic therapy produced by drugs. Psychanalytic Quarterly 1957;26: 190-205.

Ban TA. Psychopharmacology. Baltimore: Williams & Wilins; 1969, p. 370.

Klein M. Contributions to Psychoanalysis. 1921-1945.London: Hogarth; 1948.

Stacey CH, Azima H, Huestis  DW, Hoffman MM. Jaundice occurring  during the administration of chlorpromazine. Canadian Medical Association Journal 1955; 73: 386-92

Antonio E.Nardi
September 25, 2014