Hector Warnes’ comment

Hanfried Helmchen: My professional development in clinical psychopharmacology


          Professor Helmchen wrote a brief auto- biographical account, largely on his contributions to the development of psychopharmacology, adding several vignettes of his outstanding career in the field of research, the neurosciences, neurophysiology, clinical neurology and particularly the field of epilepsy. In basic science, his research on the blood-brain barrier and the effect of neuroleptic drugs on the EEG of epileptic and non-epileptic patients were widely cited.

            He was born in Berlin on June 12, 1933. Briefly, he writes about his trip to Washington in 1966, accompanied by his wife, in order   to attend the CINP Congress which led him to Baltimore (the Phipps Clinic) where he visited the physiologist Horsley Gantt who already had met Helmchen’s parents at the Kaiser Wilhelm Institute for Brain Research in Berlin. The name of the Kaiser Wilhelm Institute was later changed to the Max Planck Institute.   In 2003 the Department of Medicine of the Free University of Berlin and the Medical Faculty of the Alexander von Humboldt University in Berlin were merged and called Charité University.      Helmchen dared to attend the 7th CINP World Congress held in Prague in 1970, a year after the “Prague Spring,” attendance judged negatively by many of his American colleagues who boycotted the meeting.

            Since his graduation in Medicine at the Charité Medical School of the Free University of Berlin in 1955 he completed a Doctor´s degree at the University of Heidelberg in 1956. Between 1955 and 1958 he was resident of the Department of Neurology in Heidelberg and spent some time at the Victoria Hospital in Australia. His training in Research was completed at the Max Planck Institute for Research of Heidelberg.  He returned to his alma mater and rose to become the Professor and Chairman of the Department of Psychiatry and Psychotherapy at the Free University of Berlin between 1972 and 1999.

            Since 1999 he is Professor Emeritus and continues to be a leader in the field of Psychiatry. He has contributed to science and the humanities, particularly in the field of ethics and the political misuse of psychiatry. His latest publication is on the Janus face of Psychiatry with a subtitle of the uses and risks of psychiatric treatments.  During his distinguished career, he has been eclectic, supported a biopsychosocial model and, in psychopathology, proffered a Gestalt model of mental illnesses.

In contrast to H. Landolt on  the “forced normalization” of the EEG  (in comparison with previous and subsequent EEGs) in epileptics who underwent a psychotic episode, Helmchen found in a study of 100 female patients with paranoid hallucinatory psychosis that  “the development of paroxysmal dysrhythmia was correlated with a therapeutic response and vice versa a not modified “hyper rigid” EEG with a lack of response and the development of foci predominantly on the right temporo-parietal brain region which correlated  with  the formation of a psychopathological residual states” (1968).

            He elaborated on K. Heinrich’s work on the neuroleptic-induced post-remissive depression or exhausting syndrome.

            Prof. Helmchen wrote on biperiden in association with neuroleptics, inducing in older patients a delirium and, in some cases, fatalities.

            He had an extensive clinical and research experience with the use of Perazin (Taxilan), a chlorpromazine derivative and wrote a book on the subject. He also worked on Lithium-catamnesis (follow-up) with Bruno Müller-Oerlinghausen (1977). His research on the benefits versus the risks of using clozapine in refractory cases was instrumental in putting the drug back in the market under stricter medical controls.  His many publications on psychiatric classifications and particular the AMDP system was published by the INHN.

            He was editor and wrote on Psychiatry of the present (Psychiatrie der Gegenwart) which is in its fourth edition and I believe that has already five volumes.

            An interesting aspect of Professor Helmchen is his question of value judgements in “labeling” psychiatric patients and its negative effects. He is of the opinion that the frontiers between normal and abnormal are often blurred and that there are two thresholds to define.

Unfortunately, Professor Helmchen did not elaborate on most of his work, he just listed them.  I would have liked to become acquainted with his views on ethics in psychiatric research, his views on naturalistic versus controlled trials, the implications of placebo-controlled clinical trials, the question of informed consent of psychiatric patients, the evidence of evidence based medicine, his work on geriatrics and so on.

            He received many honors, as expected, for his brilliant and prolific career in medicine, neurology, research, clinical psychiatry and the humanities. He was president of the DGPPN (Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde). Was member of the Brandenburg Academy of Science, member of the Leopoldina National Academy of Science, fellow of the American Psychiatric Association, of the World Psychiatric Association and in 2015 received the Wilhelm Griesinger (1817-1868) medal.

            I am honored to be asked to review his book, the Janus face of Psychiatry, and look forward to beginning the task.


December 21, 2017