Advancing the Treatment of Mood and Anxiety Disorders: The First 10 Years’ Experience with Paroxetine

The last half of the 20th century witnessed remarkable advances in psychiatry that began with serendipity and were realized through the combined efforts of astute clinical observation, scientific investigation, and patient advocacy. The modern era of psychopharmacology of mood disorders began in the late 1940s with John Cade’s discovery of the mood-stabilizing properties of lithium. Less than five years later came the unexpected observation of elevated mood and activation among patients on a tuberculosis ward who were treated with the antitubercular agent, iproniazid. Subsequent clinical trials led to the widespread, but short-lived, use of iproniazid for treatment of depression in 1957 and the demonstration of its monoamine oxidase inhibitor properties.