Kline, Nathan Schellenberg

   (1916–1983)

   Kline grew up in Atlantic City, New Jersey, in a family that owned a chain of department stores; his mother, Flora Schellenberg, was a physician. After studying psychology at Harvard graduate school in the late 1930s, Kline went into medicine and graduated with an M.D. from New York University in 1943. He began training in psychiatry at St. Elizabeths Hospital in Washington, D.C., served in the Second World War, and in 1946 worked as a research assistant at Columbia University’s medical school. In 1950, he became research director at Worcester State Hospital in Massachusetts, one of the oldest state hospitals in the United States. He finally became a board-certified psychiatrist in 1953, shortly after leaving Worcester to become research director at Rockland State Hospital in Orangeburg, New York. At Rockland, he would stay for the rest of his days, until his death in New York City of an aortic aneurysm. In 1975, his unit became the Rockland Research Institute. Between 1957 and 1980, Kline also had an academic affiliation with Columbia.

   One of the pioneers of psychopharmacology in the United States, Kline made two major discoveries. In 1954, he confirmed the effect of various extracts and alkaloids of the plant Rauwolfia serpentina Benthan, especially the alkaloid reserpine (already in use against hypertension), in chronically ill psychiatric patients. Using a placebo-controlled trial, Kline discovered that R. serpentina significantly reduced anxiety in psychotic patients, making them "able to talk more freely during psychotherapy." It also exerted a "tremendous[ly] relaxing and tranquilizing effect" on restless and tense patients, making insulin coma therapy unnecessary for some. As well, "dreams became vivid and easily remembered." Kline’s report in the Annals of the New York Academy of Sciences launched reserpine on its brief career as an antipsychotic and antianxiety drug before it went out of fashion in psychiatry because of side effects (the accusation that it induced depression seems to have been a canard). In 1957, Kline won a Lasker Award for this work.

   In 1957, Kline and two colleagues reported at a psychiatry meeting their clinical experience with the antituberculosis drug iproniazid on apathetic and depressed patients in hospital and in his private practice in Manhattan. Kline also recounted the drug’s effect on himself. Contrary to what previous researchers had believed, iproniazid seemed effective in various psychoneuroses, and the researchers—who later ended up in ligitation over their various roles—called it a "psychic energizer." It was one of the early drugs that acted upon monoamine oxidase in the brain and hence were termed monoamine oxidase inhibitors, or MAOIs, useful especially in the treatment of depression. Kline published the work in June 1958 in the Journal of Clinical and Experimental Psychopathology, and for it he won a second Lasker Award in 1964. In the often gray world of academic psychiatry, Kline cut an unusually colorful figure. He was frequently described as "hypomanic." "His private practice was like something out of a Hollywood movie," said Michael Shepherd. A grateful patient made it possible for Kline and fellow psychopharmacologists to meet every year in some luscious Caribbean setting, a convocation named in her honor as "the Denghausen Group." From this group emerged the idea of the first large international lithium trial. In 1955, Kline testified for the first time before the United States Congress on the need for federal support of psychopharmacology, and before long large sums were flowing into the coffers of the National Institute of Mental Health. There is no doubt that Kline’s role as advocate hastened the adoption of psychopharmacology in the mainstream of American psychiatric practice at a time when psychoanalysis predominated.