Pioneer treated mentally ill with drugs

Dr. Frank J. Ayd Jr., a psychiatrist who pioneered the field of psychopharmacology when he began treating schizophrenics with Thorazine in the early 1950s, died in his sleep March 17 at Lorien Mays Chapel Health Care Center in Baltimore. He was 87.

At a time when the psychiatric establishment rejected the notion that mental illness was rooted in biology, Ayd championed the use of medications to adjust brain chemistry and relieve a patient’s suffering.

“He was a biological psychiatrist, one of the important kinds of people who in spite of -- and against -- the establishment had the guts to stand up and really do things,” said Dr. Thomas Ban, an emeritus professor of psychiatry at Vanderbilt University in Nashville. “Many people claim pioneering, but he really was. He entered the field when the whole thing started.”

Dr. Philip G. Janicak, a Chicago psychiatrist and editor of International Drug Therapy Newsletter, said, “Dr. Ayd was one of the founding fathers of modern psychiatry. He changed the direction of psychiatry.”

Born in Baltimore and raised near Johns Hopkins Hospital, Ayd was the son of a pediatrician and grandson of a pharmacist.

He earned his bachelor’s degree from Loyola College in 1942, then entered the University of Maryland Medical School, where he was halfway through a residency in pediatrics when the Navy called him to active duty in 1943. While in the Navy, he attended medical school and graduated in 1945.

One of his early assignments was to the U.S. Veterans Hospital in Perry Point, Md., where he served a two-year residency in psychiatry from 1946 to 1948.

“Perry Point predominantly had people who had been sick for years and years. I had patients from the Spanish American War through World War II,” Ayd told Psychiatric Times in 2005.

“Some had been at the hospital 20, 40, 60 years. Many [clinicians] used to say, ‘All ye who enter here should abandon hope,’ because we didn’t have effective treatments for them [the mentally ill] in those days,” he said.

His patients included those who were unable to experience pain or distinguish hot from cold, those who heard voices and those who were engulfed by hallucinations or were violent.

In an era that favored psychoanalysis and electroconvulsive therapy, Ayd began experimenting with drugs to treat patients.

In 1950, Ayd went into private practice and three years later Smith Kline & French asked if he would be interested in evaluating Thorazine, an antipsychotic medication, for patients who suffered from delusions.

Ayd said in a 2003 interview with the University of Maryland Medical School’s alumni bulletin that the results after administering Thorazine were “so dramatic it was unbelievable what could be done with that drug.” Patients were calmed and their delusions faded somewhat.

Because of his success with Thorazine, Ayd received the first permit from the U.S. Food and Drug Administration to use the drug in the treatment of schizophrenia.

His success with the drug convinced him that it might work for other patients, and he studied various other drugs.

“I was sort of looked on as a renegade,” Ayd said in the University of Maryland interview. “I was fresh out of medical school and working in a community dominated by psychoanalysis.”

Dr. J. Raymond DePaulo Jr., director of psychiatry at the Johns Hopkins School of Medicine, said Ayd was an original thinker and clinician.

“He was a truly amazing character and exactly the kind of person you’d want at a time when your ideas are out of favor,” DePaulo said, adding: “He was fearless and would say, ‘Let’s go. Let’s not stop now.’ He was not a laboratory researcher but a clinical pioneer.”

In the 1950s, Ayd founded the International Drug Therapy Newsletter, the first -- and for many years the only -- publication to focus on the use of medications for psychiatric illness. There, he documented not only the benefits of drugs for depression, schizophrenia and other ills but their numerous side effects as well.

Though he pioneered the field of psychopharmacology, Ayd still saw value in psychoanalysis and psychotherapy.

“You are treating a human being, and you have to take into consideration the requirements of that human being,” he told Psychiatric Times.

Ayd was a founder of the American College of Neuropsychopharmacology in Nashville. He was chief of psychiatry at Franklin Square Hospital in Baltimore from 1955 until 1962, when he left to lecture on psychopharmacotherapy in Europe.

From 1962 to 1965, he served as the first lay professor at Pontifical Gregorian University and hosted a weekly show, “Religion and Science,” on Vatican Radio.

After returning to Baltimore, Ayd resumed his medical practice and was director of professional education and research at Taylor Manor Hospital in Ellicott City, Md., from 1969 to 1986. He retired in 2003.

Ayd was the author of “Recognizing the Depressed Patient” and wrote two editions of “Ayd’s Lexicon of Psychiatry, Neurology and Neuroscience.” He also contributed work to three editions of “Principles and Practice of Psychopharmacotherapy.”

Ayd is survived by his wife of 64 years, the former Rita Anne Corasaniti; five sons, seven daughters, 32 grandchildren, 38 great-grandchildren, a brother and two sisters.