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March 5, 2008

The Loss of Serendipity in Psychopharmacology

Author Affiliations

Author Affiliations: Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience, NYU Child Study Center, NYU Medical Center; Nathan S. Kline Institute for Psychiatric Research; and Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York.

JAMA. 2008;299(9):1063-1065. doi:10.1001/jama.299.9.1063

This Commentary on the psychopharmacological revolution focuses on 2 mysteries: fostering medication discovery and finding out how they work. When I entered psychiatric training in 1953 at Creedmoor State Hospital, a 6000-bed institution with few therapeutic aspirations, psychotropic drugs were an impossible dream. For those individuals who have not had such an experience, an extremely morbid imagination is needed to conjure up that bedlam. It was rendered just tolerable by knowing that this training made one fit to be a candidate psychoanalyst. The next 2 years were spent at the US Public Health Service Hospital in Lexington, Kentucky, a 1000-bed federal therapeutic prison for opioid addicts, which amazingly included the most advanced center for human psychopharmacological experimentation in the world. The Addiction Research Center, led by the rigorous scientists Wikler and Isbell,1 incisively demanded objective, unbiased work and conducted pioneering studies of chlorpromazine, reserpine, and lysergic acid diethylamide.

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