Neuropsychopharmacology the first fifty years
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- Bu səhifədəki naviqasiya:
- Kurland
- Rickels
- SARWER-FONER 2
- Turner
- UHLENHUTH
- The Excerpts 1962 ELKES 1
- 1966 COLE 2
- 1974 HOLLISTER 2
- 1980 LASAGNA
- 1982 COOK
Kurland: 1960. I learned about it from Frank Ayd. Frank Ayd was one of the original members who had been involved with some of the others and got the ACNP started. And when I heard about it, I said, “Hey, I want to come to your meetings”. So he says, “You’re welcome”. I think I attended the second meeting, and then others began to join, too, because in those very heady days at the ACNP meetings, everybody was on the verge of a major discovery of one kind or another. But the interesting thing is, over the years that we carried on our research, and everything we were involved in - and we were involved in some very tenuous and sensitive areas - we never got in any trouble. Hollister: Each person has a somewhat different experience with hallucinogens. So, you know, it’s a different kind of reaction, I guess depending on our own personality, to so much of an extent that it’s hard to quantitate it. Kurland: It’s hard. I went through a couple of years of analysis and I sometimes say to myself, well, what did it accomplish for me? I’m not so sure, maybe better insights, maybe a more humble attitude towards myself, my fellow man, maybe a capacity for tolerating the shortcomings of others. The other thing that’s very important, that nobody realizes, is that the organization of the ACNP, with the structure and the role it has played in getting drugs, getting people interested, and making it available for the younger generation, the people that are about to carry on the organization was a tremendously important development. Carpenter presents his papers, Tamminga presents her papers at the ACNP, and we need that. We need those kinds of activities. Hollister: Well, the remarkable thing about the ACNP is the ability to bring together so many different disciplines, so we can talk to one another. For instance, when I go to the ACNP meetings, I don’t go for the things that I know about. I always go for the things that I don’t know about; but, of course, every year there’s more and more to learn, so I have trouble making my selection. And, of course, some people like Don Klein overreacted to it by saying, we’re no longer interested in clinical psychopharmacology, and therefore he started a separate organization. Do you remember that? Kurland: No. (Albert A. Kurland interviewed by Leo E. Hollister; Volume 1.) LEHMANN Bunney:Let me ask you, since this is the ACNP, what was your involvement in the beginning with the ACNP? You were one of the founding members. Lehmann:: Yes, again, against my wishes. I remember quite a few of the people that I knew quite well asked me to join them in founding the ACNP, the American College, and we had had meetings, and I said, “well, that’s fine, but leave me out of it”. I said, “I had no time, definitely no time, and I hate institutions, anyway, and I don’t want to have anything to do with it”. Then, I think it was Malitz who told me, “well we’ll draft you”, and I said, “I don’t know what you mean”. He said, “you don’t know what drafting is”? So he explained to me what drafting is, and so anyway, they got me into it, and, I finally became one of the founders. . Eventually, they drafted me again for being a president. I think it was in 1964. Again, I didn’t want to, and I said, “I don’t know anything about the procedures of running it”. Anyway, I got into it, and as I was doing it, I was learning it. Now I’m very glad that we have an ACNP. In fact, it’s very difficult to imagine that we didn’t at any time. (Heinz E. Lehmann interviewed by William E. Bunney; Volume 1.) RICKELS Healy: The world has changed since you actually began with your research. I’m sure the issues discussed at ACNP were completely different in those years compared to what they are now. Rickels: ACNP is almost 40 years old. I’m one of the charter members. When we started neuroscience hardly existed and 95 percent of the presentations were clinical. We can do things now that we couldn’t even imagine when ACNP started. Healy: How has the ACNP changed since the time it began? I understand it was a small group, much more informal, and had a lot more brainstorming sessions. Now you guys have become the establishment. You’re not the rebels you once were. Rickels: That’s right, but I think some of the older members of the ACNP are missing some of the clinical context in the current meetings. We’re becoming almost part of neuroscience. Our founders, including me, didn’t think the ACNP should be a neuroscience organization. It was supposed to apply neuroscience to clinical problems. Healy: Well, just on that point, there’s an awful lot of neuroscience happening out here at this meeting, but how much of it really feeds back into clinical practice? Rickels: I don’t know. Healy: Not a huge amount, probably. Rickels: I would say that if you are attending ACNP meetings in these years you’ll get nothing that you can apply in your practice. This wasn’t the case twenty years ago. Healy: Twenty years ago you’re saying you’d come here to these meetings and you’d get something useful for your clinical practice? Rickels: You would get something that you could apply when you went home. I also think that we have much more representation of industry now. It’s a change. Healy: Did Beecher come to these meetings? Rickels: Oh, yes. He was a member. My research was very much influenced by him. (Karl Rickels interviewed by David Healy; Volume 4.) SARWER-FONER 1 Awad:: Are there any other important historical events that you have enriched us with? Sarwer-Foner: Well, Ted Rothman played probably an abnormally large role in the founding of the ACNP. I liked the formation of the American College of Neuropsychopharmacology. But, earlier, before this group started we had informal research directors meetings, which was one of the developments that people don’t remember because the government’s involvement knocked it out very quickly. But, it was Ted Rothman more than anybody else who several years later got together the basic centers, the pharmaceutical industry, important professors who were necessarily psychopharmacologists, and researchers. (Gerald J. Saewer-Foner intervewed by A. George Awad; Volume 1.) SARWER-FONER 2 (Gerald J. Sarwer-Foner intervewed by Joel Braslow; Volume 10.) TURNER Engelhardt: Bill, if you would go back with me in time to the New York hotel room where the founding fathers of the ACNP met and crystallized the idea of the College? Turner: Well, Sid Merlis paged me one day and said “there is a meeting going on in New York, and would I like to attend, because some people were thinking about organizing a new scientific society dealing with psychopharmacology”. Well, I was delighted. So I said sure and we met in a hotel room with about nine people on three different occasions. Henry Brill and Max Fink were there. But we had, if you name some of these other people… Engelhardt: Well, I will tell you that at dinner last night we were talking about this, and I jotted down the names of Heinz Lehmann and Jonathan Cole. Turner: Yes, indeed, I can confirm that, Heinz went to one of these three meetings in the hotel room in New York. . Engelhardt: Was Nathan Kline there? Turner: Nate Kline was there and Leo Hollister, I think Leo was there, anyway. Engelhardt: Jon Cole? Turner: Jonathan Cole. We met in that hotel room, and eventually, it was decided to start a new organization that became known as the American College of Neuropsychopharmacology. I really had almost nothing to do with it. I was sort of a passive observer and participant, and keep in mind that I was not an organizer; I was just going along. But it was a wonderful thing because the stimulus of Thorazine was at that time keeping all of us just thrilled to the possibility that we could find something better, something more lasting, and that we could really, really accomplish something. So the papers were drawn up and the arrangements were made for this college to be established, and we used to meet in a hotel in Washington for, I guess, the first four or five years. Engelhardt: Do you know if at these four meetings in Washington, include an increasingly larger numbers of people? Turner: Oh, yes. The idea was that this organization would consist of one-third of government people, one-third industry people and one-third university people, and the membership would be kept small enough so that we could all interact actively instead of just sitting passively to listen to lectures. And that has worked out very well, except now the pressure is to increase the size, so that each time when I come to these meetings, there are fewer and fewer people that I know. (William J. Turner interviewed by Jo Ann Engelhardt; Volume 1.) UHLENHUTH (Eberhardt E. Uhlenhuth interviewed by Jerome Levine; Volume 4.) THE PRESIDENTS AND THE STORY OF ACNP From the 33 founders interviewed 10 (Cole, Cook, Elkes, Freedman, Friedhoff, Hollister, Killam E, Killam K, Lehmann and Uhlenhuth) were elected presidents of ACNP. In this section excerpts, relevant to the story of ACNP are presented from the 41 interviews conducted with 34 of the first 50 Presidents of the College. (See, Appendix Two.) One of the presidents (Cole) was interviewed three times; six (Detre, Elkes, Hollister, Klein D, Meltzer and Simpson) were interviewed twice; 26 were interviewed once; and two (Eva and Keith Killam) interviewed each other. Thirty of the 41 transcripts, based on interviews with 29 presidents provide information relevant to the story of the ACNP. At the end of each excerpt the name of the interviewee and the interviewer, as well as the volume in which the full transcript appears is noted. Each President in his/her year of office comments on issues of varying concern to the membership at that point in time in the history of the College. Most Presidents allude to one or two such issues in passing while discussing a range of concerns confronting the College. You get a sense, therefore, of which of its initial characteristics and its mission stayed the same and how certain things changed during the life of the College over these 40 to 50 years. Fridolin Sulzer draws from the first President, Joel Elkes, his overview in 1961 on the conceptual basis for the College: “In the 1960’s there was a lot of fluidity and mobility in the field crossing over into disciplines. There was an emerging understanding that there are four footings of the new discipline: neurochemistry, which was maturing so to speak, electrophysiology, animal behavior and clinical trials. These were the four footings which I saw as essential elements of any psychopharmacological enterprise worth its name”. And on the structure of meetings: “the idea was to select people from different disciplines into small groups and give them the opportunity to talk to each other. That’s very simple and it developed very well. Study groups led to a sense of scholarship identity, of owning certain areas of psychopharmacology . And it worked”. And on mission: “It is not only molecular biology, it is not only electrophysiology; it is not only clinical syndromes. It is the conversation, the interaction between these areas which matters and we must do all we can to enhance the conversation. This is what the College can do like no other organization”. Issues that confront the Presidents as the years’ progress are highlighted in the excerpts. Jonathan Cole in 1962 speaks on the relative absence of conflict of interest accompanying the early role of the pharmaceutical companies and the NIH in providing modest funding for its establishment: “I think it was helpful. Without financial support, a certain amount of spark from drug companies, ACNP would not have gone forward.” And on the impact of the funding: “Nobody really worried about investigators’ arms being twisted or their minds bent by drug companies”. Then on his initiation of the NCDEU program, the funding of investigators at that time, to conduct clinical trials without drug company support, he comments on the program’s endurance: “It’s still going and has a meeting annually in Florida”. In 1972, Alfred Freedman attempted to broaden the College concept with mixed results: “I was trying to make substance abuse a legitimate subject of psychopharmacology and I don’t think I succeeded very well even though I spoke about it in my presidential address”. Leo Hollister in 1974 alerts the membership that the balance between basic and clinical science was changing: ”The ACNP in recent years has become a kind of secondary society for neurosciences, at least, in terms of program content. Neuroscience advances have been so enormous, especially in molecular pharmacology and the techniques for genetic analysis…and maybe clinicians need to develop some new approaches in our evaluating the drugs…find ways to reduce the time and cost of getting them on the market”. Donald Klein in 1981 saw new deveiopments in clinical services research as “impelling ACNP to formalizing its relationships with the heads of Federal agencies, FDA, NIH, to meet with them regarding their agendas. To re-shape the ways research grants are funded”. Herbert. Meltzer in 1985 introduced Posters to the annual meeting: “I had to fight two to three years to get them to accept posters” and encouraged closer relations with the CINP by “making contacts and establishing research relationships” that would enhance international exposure. Arthur Prange in 1987 oversaw, after several years of controversy, the establishment of the College-sponsored journal, Neuropsychopharmacology. At the end of the 1980s, Floyd Bloom eloquently expressed the state of the science: “There is so much knowledge that just discussing the new discoveries crimps the amount of mental time that you can devote to trying to put those together”, and he continued: “It’s hard for the clinicians to keep up with the pace of discoveries in the basic sciences and for the basic scientists to keep up with the evolution of thinking about the kinds of mental illness that are distinct categories”. He was concerned that the “sheer dent of discovery has forced apart the cohesive element, the intermingling of basic scientists and clinical scientists”. Richard Shader, in 1990, saw the College as becoming more political, lobbying more actively in his year: “…we got involved with advocacy groups, the highlight being when the Secretary of Health and Human Services came to our meeting”. George .Simpson in 1991 commented on the manner in which the conduct and support of clinical trials changed, was concerned that differently from the early days when the NIH provided financial support, the current sponsors, the drug companies, “dictate what the results are going to be. People are unlikely to design a study that could possibly go against what they would like to see”. Roger Meyer in 1993 observed “a great research renaissance in the addiction field and alcoholism and ” watching its impact on the ACNP during the past four decades, he notes that “the field is poised to take advantage of molecular biology…to understand pathophysiology…It is important now to interest Industry in the need to develop drugs to treat addiction”. Thomas Detre in 1994, saw a new goal for ACNP, i.e., “coping to insure an adequate number of clinical pharmacologists”, but was concerned with reduced funding for science and saw ”the focus shifting to translational science….clinical science staying with the ACNP, but not the basic sciences”. He is concerned that the College “may be getting slightly too large for its own good and losing the informality and collegiality of its meetings”. He also, wanted to see its lobbying role diminished and “expert witnessing as probably, the best way to exert our influence ” in Congress. David Kupfer in 1995 comments on the unique impact of ACNP on the linkages that a department of psychiatry should have in training new psychiatrists, generally. On the influence of the drug companies, he saw “the College as having struck a wonderful balance” giving the companies credit for ”helping with the unrestricted educational grants” and the support of Teaching Day. Charles Nemeroff in 1997 was pleased to see that the collegiality continued over the years and that it remains an organization that “combines excellence across many sciences…suiting many needs…..and a place where he learns about areas that I simply don’t know enough about and try to take my own research to the next level”. Huda Akil in 1998 describes the organization as sitting at the interface between neurobiology and psychiatry at a time when the two should be coming together and notes that “this interface between the science of the brain and the science of the mind and how it goes wrong in psychiatric disorders, have come closer together”. Steven. Paul in 1999 was concerned with how to keep the College intellectually vigorous, to make sure that we were bringing in the young, the brightest people, continuing to evolve and saw the College as having done “a remarkable job as a catalyst” in the search to understand the brain. Alan. Schatzberg in 2000 thought that the capacity of the ACNP to maintain its role depends on filling in the gaps in membership by “actively adding expertise, some child psychiatrists, and some in research methodology and genetics… to keep ahead of the cutting edge”. In 2002, Joseph Coyle saw the science moved to the point where the College publications had expanded from the Journal and Progress volumes to the new annual “Review of Neuropsychopharmacology” concept, to be published soon, resulting in several hundred thousand dollars income for the College. Dennis Charney in 2003 comments on the expansion of the ACNP’s role on advocacy issues. They help “by providing advice…about important issues that relate to treatment”. Judith Rapaport called attention in 2008 to the need for ACNP to encourage the clinical research that could be done within the CROs, noting the benefits and citing the neglect of these areas over the years by the College. The Excerpts 1962 ELKES 1 (Joel Elkes interviewed by Fridlin Sulser; Volume 1.) 1962 ELKES 2 See Founders. (Joel Elkes interviewed by Fridolin Sulser; Volume 10.)
See Founders (Heinz E. Lehmann interviewed by William E. Bunney; Volume 1.)
(Jonathan O. Cole interviewed by Leo E. Hollister; Volume 4.) 1966 COLE 2 (Jonathan O. Cole interviewed by Thomas A. Ban; Volume 9.) 1962 COLE 3 See Founders. (Jonathan Cole interviewed by Carl Salzman; Volume 10.)
See Founders. (Alfred M. Freedman interviewed by Thomas A. Ban; Volume 1.)
See Founders. (Leo E. Hollister interviewed by Frank J. Ayd; Volume 1.)
See Founders. (Leo E. Hollister nterviewed` by Thomas A. Ban; Volume 9.)
See Founders. (Keith F. Killam interviewed by Eva K. Killam; Volume 2.)
See Founders. (Arnold J. Friedhoff interviewed by Benjamin S. Bunney; Volume 5.)
(Fridolin Sulser interviewed by Leo E. Hollister; Volume 3.) 1980 LASAGNA (Louis Lasagna interviewed by Donald F. Klein; Volume 1.) 1981 KLEIN D Hollister: Well, that’s an interesting career you’ve had and more to come, I think. Klein: It was also fun being involved with ACNP; it’s a very elite organization. People, who are in it are very smart successful people. One of the problems, I believe, with being successful is that it makes you somewhat conservative you don’t want to rock the boat too much, because, after all, you’ve done all right. But there have been a number of developments recently that I think should shake us up in terms of how psychopharmacology is going to go research wise in ensuing years, both, from the point of federal support and from the point of view of pharmaceutical industry support. I think the ACNP could play some proactive roles there. I hope it will do. Hollister: Well, you’ve been a creative thinker in this line, on the more general political line, too. What do you think the ACNP should do? Klein: Well, I think, for one thing, the ACNP ought to try to formulize a relationship with the various heads of the federal agencies, including the FDA and NIH and so forth, and to meet with them regarding their agendas. Like, for instance, I’m the head of a mental health clinical research center and I’m not at all certain as to whether mental health clinical research centers are viewed favorably as being a sensible way to spend money. I personally think that psychiatry is in a relatively primitive state as compared to, say, internal medicine. They’re way ahead of us in objective measurements and physiological understanding. Are RO1s by independent investigators a really good sensible way of funding research? Hollister: That’s sort of Rosalyn Yalow’s idea. You provide support to individuals rather than huge amounts of money to centers. Klein: I think for Rosalyn that makes great sense, but I think for psychiatry, we still need to get critical masses together who can collaborate as experts in a variety of fields, because we’re nowhere near Rosalyn Yalow. And, for that reason, centers make sense in psychiatry. It would be interesting to have a discussion about that with someone like, Dr. Harold Varmus. (Donald F. Klein interviewed by Leo E. Hollister; Volume 4.) 1982 COOK (Leonard Cook interviewed by Larry Stein; Volume 1.) 1983 BUNNEY W Ban: You’ve gotten several honors and awards. Would you like to mention a few? Bunney:: I would say election to the Institute of Medicine / National Academy of Science, the Presidency of four organizations: Psychiatric Research; The West Coast College of Biological Psychiatry; The American College of Neuropsychopharmacology, and the Collegium Internationale Neuro-Psychopharmacologicum. The highest honor was certainly the ACNP presidency in that group (William E. Bunney interviewed by Thomas A. Ban; Volume 5.) Yüklə 1,42 Mb. Dostları ilə paylaş:
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