Alec Coppen
Pioneering psychiatrist who explored the link between depression and levels of serotonin in the brain
DR ALEC COPPEN, who has died aged 96, was a psychiatrist who was among the first to investigate the link between low levels of the brain chemical serotonin and clinical depression.
Coppen was hailed as a pioneer of psychopharmacology – the scientific study of the effects of drugs on the mind and behaviour – at a time when such research was often regarded with suspicion. In 1967 he expanded upon the dominant “chemical imbalance” theory of depression, which proposed that antidepressants worked by increasing the amount of norepinephrine available in the central nervous system.
Coppen’s research suggested that there were other chemicals implicated in mood disorders, in particular a neurotransmitter called serotonin. In this theory the depletion of serotonin levels could promote or “permit” a fall in norepinephrine levels. So manipulating levels by giving tryptophan – an amino acid which is converted to serotonin in the brain – might help those who were already on antidepressants to get better faster than those who stuck with more traditional treatment.
Though the benefits of tryptophan were later contested in later studies, Coppen’s theory became one of the most influential in psychopharmacology. He went on to investigate the effects of taking antidepressants alongside a variety of other supplements, some of which produced clear improvements. Many depressed patients, for example, did better when given vitamin B12 and folic acid in addition to the standard pill regimen.
In the 1970s Coppen braved controversy by wading into the debate on the merits of lithium, used to treat manic depression and recurring depressive illness. While several studies had indicated that lithium might protect patients from relapses, the Institute of Psychiatry remained unconvinced.
The results of Coppen’s own controlled trial, published in 1971, came down on the side of lithium therapy, and he went on to champion its effectiveness in treating both unipolar depression and manic or bipolar depression (characterised by mood swings alternating between intense sadness and mania).
Coppen and his collaborators went on to establish a lithium clinic – “because this obviously was a service which we should offer our patients”, as he put it. In a later study Coppen followed up on several patients who had attended the clinic, discovering that the group had a much lower suicide rate – “less than one per thousand … [against] a suicide rate of seven per thousand, which is the norm.” It was this ability to prevent depressive relapses which proved, as a fellow researcher put it, “the miracle of lithium”.
Alec James Coppen was born in Streatham on January 29 1923, the third son of Herbert Coppen, an employee of the United Africa Company, and his wife Marguerite (née Henshaw).
After Dulwich College Alec joined the Royal Signals in 1942 and was selected for commando training, but contracted septicaemia and tuberculosis. After treatment he returned to light duties and was demobbed in 1946.
With the encouragement of his GP he decided to read Medicine at Bristol University, qualifying in 1952. He then became a registrar (later senior registrar) at the Maudsley, followed by a stint at the Medical Research Council’s Neuropsychiatry Research Unit.
Coppen developed an interest in the biological effects of stress and illness. One study showed that women giving birth for the first time were more likely to suffer from pre-eclampsia (a potentially serious condition characterised by high blood pressure) if they were going though personal difficulties, such as being evicted from their lodgings.
Another study looked for correlations between certain psychiatric illnesses and a patient’s physical traits, such as their build. Together with Neil Kessel he conducted one of the earliest studies of premenstrual syndrome, helping to break down the taboos of the era by asking 500 randomly selected women to describe how their experience of symptoms including pain, irritability and low mood was related to their monthly cycle.
From 1964 until his retirement in 1988 Alec Coppen was a consulting psychiatrist at West Park Hospital in Epsom, Surrey. He was a consultant for the World Health Organisation from 1970 and served as president of the International College of Neuropsychopharmacology from 1988 to 1990. He was made an honorary fellow of the Royal College of Psychiatrists in 1995, and in 2000 he received the Pioneer in Psychopharmacology Award.
A keen opera-goer and a frequent visitor to museums and galleries, in retirement Coppen achieved his aim of seeing all 37 Shakespeare plays performed.
He married, in 1952, Gunhild Andersson; they had a son, and she died in 2007.
Dr Alec Coppen, born January 29 1923, died March 15 2019