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Between psychopharmacology and existential analysis, Roland Kuhn and the discovery of imipramine Volume 99, issue 2, Février 2023

Author
Psychiatre honoraire
* Correspondance : S. Chebili
Rubrique coordonnée par Eduardo Mahieu

Roland Kuhn, a student of Binswanger, was a psychiatrist at the asylum in Münsterlingen, Switzerland. The Swiss laboratory Ciba-Geigy gave him the molecule G22355, whose structure was close to chlorpromazine, to try it out on schizophrenic patients. He noted the worsening of psychotic symptoms. Kuhn highlighted the antidepressant effect of this substance, which he then named imipramine, the leading tricyclic antidepressant. Contrary to what his detractors claimed, Kuhn did not discover the antidepressant effect of G22355 by chance. Indeed, he neglected tests, rating scales, and randomized double-blind studies. Instead, he stated that he used his philosophical knowledge, the resources of existential analysis. Thus, he did not immediately make a diagnosis, but was attentive to the entire existence of the patient. His method, that of phenomenological intuition, was based on understanding through interpenetration with the patient’s being-in-the-world. Thus, he first created the diagnosis of vital depression, on which he was able to observe the antidepressant effect of imipramine. Roland Kuhn had a global approach to psychiatric illnesses that took into account both pharmacological and psychological aspects, adopting an essentially phenomenological perspective.