Introduction

Parkinsonism associated with drug use was first described by De in 1944 in Indian patients treated with rauwalfia alkaloids. In this situation it was observed to be a common occurrence that could be readily reversed by atropine. This was clearly seen as an adverse effect but, presumably because of its easy treatability, was not commented on as a source of clinical concern.

Those psychiatrists who had early access to chlorpromazine noted similar symptomatology associated with its use too. Patients were, as mentioned above, initially treated symptomatically for ‘excitement’ as opposed to by diagnosis, and were noted to become ‘retarded’ and to develop ‘wooden’ expressions and difficulties with gait and balance. Delay and Deniker noted features of this sort as early as 1952, but again the unmistakable impression one is left with is that this was not considered an issue of concern. At the first Largactil Symposium held in Basel in November of 1953, in response to questions from the floor, Staehelin (quoted in Caldwell, 1978) stated that:

The fact that this appeared to be readily manageable allowed it to be dealt with in a passing manner.