Joel Elkes

Towards the end of 1952, or maybe it was early 1953, Joel Elkes received a visitor in his office at Birmingham University in the UK. Nearly a half century later, Elkes recalled that the man was “very properly dressed and very proper generally,” and he said: “Professor Elkes, this is not a routine visit, do you mind if I shut the door?”1

The man, W R Thrower, medical director of the pharmaceutical firm May & Baker, unlocked his briefcase and pulled out a manuscript written by researchers in Paris who had been studying the potential of using the antihistamine chlorpromazine to treat psychotic patients.2 “We have just got this from France,” Thrower told Elkes. “Would you please read it?”

Elkes, founding chair of Birmingham’s Department of Experimental Psychiatry, the first experimental psychiatry department in the world, read the paper with “slight disbelief.” He found the results outlined in the French paper “too good to be true.”3 Elkes, in the late 1940s, had studied the potential of using amobarbital, amphetamine, and mephenesin as possible treatments for catatonic schizophrenic stupor. But his work had yielded only “paradoxical results.”4

Thrower told Elkes that May & Baker had acquired UK rights for chlorpromazine, had 500 g in the company safe, and would be glad to supply Elkes with tablets and placebos if he were to conduct a controlled trial with psychotic patients. Elkes eagerly agreed.

The result of the study of 27 chronically agitated patients with psychosis—seen by many as …