SOUBORNÝ REFERÁT History of the CINP (Collegium Internationale Neuropsychopharmacologicum)

psychiatrie_5_05 12.7.2005 15:36 Str. 258 SOUBORNÝ REFERÁT History of the CINP (Collegium Internationale Neuropsychopharmacologicum) Ban T. A. Recognition that one of the essential prerequi- to neuropsychopharmacology and through the sites of successful neuropsychopharmacological organization encourage and promote international research is a continuous dialogue between clini- scientific study, teaching and application of neu- cians and basic scientists created a need for the ropsychopharmacology.“ founding of an association which would provide Prior to the inaugural meeting there was dis- a platform for interaction among the different dis- agreement between the two main players in the ciplines of the new field. founding, Rothlin and Trabucchi, regarding membership in the organization, reflecting major dif- ferences in their expectations about the collegium. In this dispute Rothlin prevailed and membership THE FOUNDING OF CINP was restricted to those actively involved in the new field instead of being open to all interested in To start the dialogue between clinicians and the new drugs. However, as a compromise, it was basic scientists an International Symposium on decided that congresses should alternate between Psychotropic Drugs was hosted by Emilio Trabuc- „open“ meetings with free attendance for everyone chi, chairman of the department of pharmacology, interested in the field, and „closed“ meetings with and Silvio Garattini, a young pharmacologist, at attendance restricted to CINP members and their the University of Milan in May 1957. On the sec- invited guests. The idea was that open meetings ond day of this symposium Wolfgang de Boor, with larger audiences would provide a forum to a psychiatrist working in Cologne, Germany, and communicate new developments in neuropsy- Corneille Radouco-Thomas, a pharmacologist chopharmacology. By contrast, closed meetings working in Geneva, Switzerland, proposed the would allow for interaction among the disciplines, founding of an „international association“ to pro- the provision of feedback from clinicians to basic vide a forum for interaction between clinicians and scientists, and the conversion of findings in pre- basic scientists for the study of psychotropic drugs. clinical neuropharmacologic research into clinical The formal inauguration of CINP took place psychopharmacologic hypotheses. four months after the Milan Symposium, during The 1st CINP Congress – organized by Emilio the Second World Congress of Psychiatry in Trabucchi – was an open meeting in 1958 in Rome, Zurich, on September 2, 1957, at a dinner meeting, Italy, with about 500 participants from 26 countries hosted by Rothlin, in the buffet of the city’s rail- [5]. Its central theme was drug-induced behavior; way station. By the end of the dinner Rothlin, and the symposia were dedicated to methods of a former director of Sandoz, was elected president, analyses of drug-induced behavior in animals and W. A. Stoll, treasurer, Corneille Radouco-Thomas man; to the comparison of abnormal behavioral and Herman Denber, secretaries, and Pierre states induced by psychotropic drugs in animal and Deniker and Philip Bradley, councilors. The 32 man; and to the comparison of drug-induced and invited guests became the founders of CINP [1]. endogenous psychoses. The Congress provided a platform for Julius Axelrod, an American bio- chemist who was to receive the Nobel Prize, to pre- sent his discovery that catechol-O-methyl trans- TRANSLATION OF FINDINGS ferase plays a role in the inactivation of norepinehrine (NE), which led to the transmethyla- What are the aims of CINP? According to its tion hypothesis of schizophrenia; for Manfred Constitution and By-Laws, drafted in 1957, the Bleuler, a prominent Swiss psychiatrist, to express primary objective of the organization is „to estab- his belief that one should not expect that anomalies lish (provide for) an organization whose members of NE or serotonin (5-HT) could explain the patho- shall meet from time to time“ at least once every genesis of schizophrenia; and for Pierre Lambert, two years, „to consider and discuss matters related a young French psychiatrist, to propose a classifica- Presented at the CINP Regional Meeting in Brno, Czech Republic, September 10, 2004. 258 psychiatrie_5_05 12.7.2005 15:36 Str. 259 tion of neuroleptics, prepared by the Comité Lyon- one topic, was optimal for interaction and should naise, in which neuroleptics are divided into „seda- have been adopted at future meetings. But this did tive,“ chlorpromazine-type (which are less potent on not happen. The 5th CINP Congress, an open meet- a mg per kg basis and produce drowsiness and las- ing, organized by Jonathan Cole (69) during Jean situde with relatively few extrapyramidal signs Delay’s presidency, in 1966 in Washington, DC, [EPS]) and „incisive,“ prochlorperazine-type (which United States, featured 14 scientific symposia cov- are more potent on a mg per kg basis and produce ering many areas of neuropsychopharmacology ataraxy without drowsiness but with frequent and [7]; and the 6th CINP Congress, a closed meeting, marked EPS). organized by F. G. Valdecasas during his presiden- The 2nd CINP congress – organized by Ernst cy (1966–168), in 1968, in Tarragona, Spain, Rothlin, during the second term of his presidency accommodated as many as eight free communica- (1958–1960) – was a closed meeting in 1960 in tions sessions with widely different topics [9]. Basle, Switzerland, with about 250 participants By the end of the 1960s, despite of the restric- [21]. The program focused on methodological tion of membership to those actively involved in issues relevant to the detection of the mode of the new field, interaction between basic scientists action and the therapeutic effects of psychotropic and clinical investigators decreased at the bienni- drugs. It was at the Basle meeting that Arvid al meetings, and clinical feedback was largely dis- Carlsson, a Swedish pharmacologist who was to missed. Since by the early 1970s conversion receive the Nobel Prize, presented his findings on (translation) of findings from one discipline to selective changes in brain monoamines with psy- another to establish relationships, e.g., between chotropic drugs. This was to provide the theoreti- structural changes and activity, was no longer of cal framework that dominated neuropsychophar- central importance at the meetings, the only dif- macology for well over two decades. It was also at ference remaining between open and closed meet- the Basle meeting that Fritz Freyhan, one of the ings was in the number of registrants. However, American pioneers of psychopharmacology, called alternation between open and closed meetings lin- for a „critical examination“ of the commonly held gered on until the mid-1980s. belief that there is a linear relationship between neuroleptic potency and therapeutic effects. By presenting clinical evidence that „compounds showing higher frequencies of hyperkinetic syn- COMMUNICATION OF FINDINGS dromes also have higher failure rates“ in treatment, he provided the kind of feedback for During the 1970s pharmacotherapy with psy- researchers involved in psychotropic drug develop- chotropic drugs became the primary form of treatment that might have prevented the detour in the ment in mental illness; psychiatrists involved in pharmacotherapy of schizophrenia that entailed psychopharmacology were becoming part of the „high potency“ neuroleptics, and the accompany- psychiatric establishment; and CINP congresses ing high prevalence of tardive dyskinesia in neu- were transformed into meetings with less and less roleptic-treated patients. emphasis on interaction and feedback, and with rd The 3 CINP Congress – organized by Dieter more and more emphasis on presentations on new- Bente, Hanns Hippius, and Fritz Flügel during ly emerging areas of research. The 7th CINP Paul Hoch’s presidency (1960–1962) – was an open Congress – organized by Zdenek Votava and meeting in 1962 in Munich, Germany [6]. It was Oldrich Vinar during Heinz Lehmann’s presidency the 10th anniversary of the introduction of chlor- (1968–1970) – in 1970, in Prague, Czechoslovakia, promazine (CPZ), and the meeting provided an included symposia on lithium with special atten- opportunity to critically examine ten years of psy- tion to the prophylactic treatment of bipolar disor- chopharmacology. der; on amine precursors with special attention on The 4th CINP Congress – organized by Philip the treatment of affective disorder; and on the Bradley during Hans Hoff s presidency evaluation of anxiolytic drugs [23]. The 8th (1962–1964) – was a closed meeting in 1964 in Congress – organized by Eric Jacobssen during his Birmingham, England [3]. The program was presidency (1970–1972) – in 1972, in Copenhagen, uniquely structured in that the first day was de- Denmark, featured the pharmacotherapy of sexu- dicated to a plenary session in which speakers al disorders, and the long term effects of psy- with different backgrounds introduced the central chotropic drugs [2]; the 9th – organized by Jacques theme from their own point of view; the second Boissier during Hanns Hippius’ presidency – in and third days were given to discussion in working 1974, in Paris, France, looked at the effect of drugs groups; and the fourth and final day to a second on cyclic AMP in the brain, and at genetics in psy- plenary session at which deliberations of the work- chopharmacology [4]; the 10th – organized by ing groups were summarized in reports. Radouco-Thomas and André Villeneuve during

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