Lives of the fellows

Alec James Coppen

b.29 January 1923 d.15 March 2019
MB ChB Bristol(1953) DPM(1957) MD(1958) FRCPsych(1971) MRCP(1975) DSc(1978) FRCP(1980) Hon FRCPsych(1995)

Alec Coppen, clinical director of the Medical Research Council’s (MRC) unit for neuropsychiatric research at West Park Hospital, Epsom, was a pioneering psychiatrist and psychopharmacologist who discovered the role of serotonin in the aetiology of depression and the anti-suicidal effect of lithium.

Alec Coppen was born in London, the son of Herbert John Wardle Coppen, an accountant, and Marguerite Mary Annie Coppen née Henshaw. He was educated at Dulwich College and served in the Army from 1942 to 1946 as a commando officer in the Highlands of Scotland. During his time in the Army he caught septicaemia and pulmonary tuberculosis, both potentially fatal illnesses in the era before antibiotics, but later felt ‘these illnesses saved me from more life-threatening situations in Normandy’.

Following his demobilisation, he studied medicine at the University of Bristol. He held house posts at Bristol Royal Infirmary and then trained in psychiatry at the Maudsley Hospital, where he started his research work in biological psychiatry. He gained his MD in 1958.

He was headhunted by the MRC and was on its external staff, before becoming clinical director of the MRC’s unit at Epsom in 1959, a role he stayed in until his retirement in 1988.

His seminal paper in The Lancet in 1963 showed that the amino acid tryptophan markedly potentiated the antidepressant action of MAOIs (‘Potentiation of the antidepressive effect of a monoamine-oxidase inhibitor by tryptophan’ Lancet. 1963 Jan 12;1[7272]:79-81). He pursued the serotonin theory, carrying out numerous studies, including studies of serotonin metabolites in the post-mortem brains of people with depression who had committed suicide. This work culminated in his 1967 paper in the British Journal of Psychiatry on the biochemistry of affective disorders (‘The biochemistry of affective disorders’ Br J Psychiatry. 1967 Nov;113[504]:1237-64), which has become a citation classic.

It is fair to state that the development of SSRI antidepressants have their origin in his work. He published more than 500 papers and seven books on various studies of the biology of affective disorders. His studies extended to the neuroendocrinology of depression and the role of folate in the pathogenesis of depression and its efficacy as an adjunct to antidepressants.

His other major contribution to the psychopharmacology of mood disorders was the establishment of the lithium clinic at West Park Hospital. He conducted the first placebo-controlled trial of the effectiveness of lithium salts in the prophylaxis of recurrent mood disorders, culminating in the discovery of lithium’s unique anti-suicidal effects, concurrently with two German research groups in Berlin and Dresden.

He also conducted the trial of the optimum dosage of lithium, establishing its minimum effective dose for prophylaxis. He studied its adverse effects on renal and thyroid functions to establish standards for safe medical practice. His last paper, in 2017, was a review of the effectiveness of lithium in the long-term treatment of unipolar (recurrent) depression.

Alec Coppen won the Anna Monika prize in biological psychiatry research in 1969. He was a founding member of the British Association for Psychopharmacology (BAP) and was president from 1976 to 1978. BAP awarded him the first gold medal for lifetime achievement in psychopharmacology in 1998. He was a member of and president (from 1988 to 1990) of CINP (Collegium Internationale Neuro-Pyschopharmacologicum), the international group of psychopharmacologists and biological psychiatrists. In 2000, he was presented with CINP’s pioneer of psychopharmacology award. He was awarded an honorary fellowship of the Royal College of Psychiatrists in 1995.

Alec Coppen was well read, highly cultured and enjoyed opera and theatre. In retirement he achieved his aim of seeing all of Shakespeare’s plays performed.

Alec made a legendary contribution to biological psychiatry and psychopharmacology. He often talked about the many letters he received from patients and their families years after he retired, thanking him for his good care.

He married Gunhild (Gunnie) Andersson in 1952 and they had one son, Michael, a consultant histopathologist and two grandchildren, Daniel and Victoria.

Mohammed T Abou-Saleh

[The Telegraph 28 March 2019 www.telegraph.co.uk/obituaries/2019/03/28/alec-coppen-psychiatrist-investigated-link-serotonin-depression/ – accessed 30 June 2019; BMJ 2019 365 1731 www.bmj.com/content/365/bmj.l1731 – accessed 30 June 2019; International Journal of Neuropsychopharmacology Vol 22 (6) June 2019 371 https://academic.oup.com/ijnp/article/22/6/371/5498496 – accessed 30 June 2019]

(Volume XII, page web)

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