Medicine: Wonder Drug of 1954?

Working on an antihistaminic drug which they had developed for the control of allergies such as hay fever, researchers at France’s Rhône-Poulenc laboratories found that the drug made many people sleepy. For a world in need of sedatives, they took the logical step of trying to put together a related chemical that would make people even sleepier. What they found (in 1950) and first tagged 4560-RP, or chlorpromazine hydrochloride,* is now the most exciting new drug seeking recognition in the world’s pharmacopoeias.

By any name, chlorpromazine is a versatile and fantastically interesting drug to medical researchers. Peppery young (38) Dr. Henri Laborit, who darts from experiment to experiment in his Paris laboratory at Val de Grâce Hospital, used the brand-new chemical on animals late in 1950. He found that it worked against shock and produced the effects of hibernation. Laborit promptly organized a research team to make the most of these effects, and from its combined efforts came the “lytic cocktail.” In this, chlorpromazine is combined with Phenergari and Dolosal to block the automatic nervous system.

For Operations & Mental Cases. With physical chilling after a lytic cocktail, a patient’s temperature can be dropped to 80° F. or even lower. His metabolism is slowed so sharply that even his brain needs little oxygen. French surgeons using the Laborit technique have performed hundreds of operations (for everything from heart disease and advanced cancer to a ruptured appendix) on patients rated as poor risks for ordinary anesthesia. Laborit reports no cases of surgical shock, and a good cure rate.

Laborit found U.S. doctors the most cautious in their approach to the new drug. They are still skeptical of his lytic cocktail, and have set 80° as the lowest temperature to which a patient can be dropped without danger of heart failure. But they have found plenty of other uses for chlorpromazine. Just as it serves as a preamplifier for anesthetics, it intensifies the effect of barbiturates and narcotics. Thus, patients with unbearable pain can get along with less morphine—and, hence, less danger of becoming resistant or addicted.

By itself, chlorpromazine is a star performer. For several types of mental patients, especially senile psychotics, it serves as a highly effective relaxer. After a few doses, says Dr. Charles Wesler Scull of Smith, Kline & French (the U.S. manufacturers), patients who were formerly violent or withdrawn lie “molded to the bed.” When a doctor enters the room, they sit up and talk sense with him, perhaps for the first time in months. There is no thought that chlorpromazine is any cure for mental illness, but it can have great value if it relaxes patients and makes them accessible to treatment. The extremely agitated or anxious types often give up compulsive behavior, a surface symptom of their illness. It is, says Dr. Scull, as though the patients said, “I know there’s something disturbing me, but I couldn’t care less.”

For Nausea & DTs. To combat nausea and vomiting—whether from heaving seas, bumpy airplanes, pregnancy, kidney disease, cancer or heavy X-ray treatment—chlorpromazine seems far superior to other drugs. It is the only one that helps victims of dysautonomia (TIME, June 7), where the cause of vomiting is deep in the nervous system. It is credited with saving several lives in especially stubborn cases of vomiting during pregnancy or from kidney disease. And chlorpromazine seems to be the answer in many cases of persistent hiccuping.

There is also the matter of the lost weekend. Given with disulfiram (Antabuse), chlorpromazine straightens out a victim of DTs within two days instead of the usual six. Some doctors find it almost equally effective alone, and its antiemetic effect can be a boon after a simple, heavy binge.

There are about 400 research projects now under way in the U.S. testing chlorpromazine on man and beast to find the limits of its usefulness and its possible dangers. Late this month 12,000 doctors at the A.M.A.’s annual convention in San Francisco will have a chance to see exhibits describing what has been learned. Papers on the subject are being published. Though the drug is now available on prescription, it is recommended so far only for vomiting and in mental illness because much has yet to be learned about it.

*Alias 2601.A (TIME, Oct. 12), trademarked Thorazine in the U.S., alias Largactil in France, Britain and Canada, Megaphen in Germany and Ampliactil in Argentina.