Mogens Schou, the lithium pioneer

Theme: Historical aspects


Only a handful of Danish psychiatrists have achieved international fame and foremost among them is Mogens Schou (1918-2005), former professor of biological psychiatry at Aarhus University and the father of modern lithium treatment.

Mogens Schou was born into psychiatry. His father, Hans Jakob Schou (1887-1952) was the director of “The Philadelphia Colony”, a large, rather unique, private institution in the countryside, where patients with epilepsy and mental disorders were treated. Mogens Schou was introduced to the distinguished psychiatrists, clinicians and researchers, who visited his fathers institution, he became familiar with the patients on the premises and he discovered the heavy load of mental disorder which haunted his own family. This upbringing formed his future career. He choose to study medicine and after training in Denmark and abroad, in 1951 he joined as a research assistant another famous Danish psychiatrist, professor Erik Strömgren (1909-1993) at the Risskov Psychiatric Hospital in Aarhus. Erik Strömgren encouraged his new assistant to study the clinical effect of lithium on manic patients. Strömgren had just read an Australian paper by John Cade (1912-1980) on this subject and found the prospect promising, although the paper was lacking in methodological rigor. Mogens Schou planned the first ever double blind, placebo controlled study in psychiatry and proved a superior effect of lithium. The paper was published in 1954. After this time Mogens Schou dedicated the rest of his long life to the study of lithium, the clinical effects and the pharmacological properties. He was appointed professor of biological psychiatry in 1972, resigned in 1988 but remained enormously productive until his death in 2005. Altogether he produced more than 600 papers, all of them related to the importance of lithium in psychiatry.

Mogens Schou, the lithium pioneer, Af Per Vestergaard, professor emeritus, Aarhus University.
Mogens Schou, the lithium pioneer (1918-2005).

Mogens Schous most important scientific achievement without doubt is his demonstration of the ability of lithium to prevent manic and depressive attacks in manic-depressive patients. Through the 1960-ties and 70-ties he published, together with Poul Christian Baastrup (1918-2002), a number of papers on this subject, but was met with doubt and suspicion from international colleagues, especially from the famous Maudsley Hospital in London. Schou and Baastrup won the contest and from 1980 no serious doubt was raised about the efficacy of lithium treatment for the prevention of mania and depression (although occasionally new attacks do emerge).

Mogens Schous clinical contributions were published in collaboration with clinicians outside Aarhus: Poul Christian Baastrup working in Copenhagen and Paul Grof (1935-) settled in Canada, just to mention the two most important. The work in Schous own research department in Aarhus mainly concentrated on the pharmacokinetic properties of lithium, an extremely important subject because of the dangerous renal side effects and the risk of intoxication. The mapping of the renal handling of lithium led to important instructions for the safe administration of lithium and the prevention of intoxication. Much of Schous later years was spent with repeated lecturing all over the world with the purpose of instructing yearning colleagues. Also the confidence of the manic-depressive patients was at his heart. To this end he wrote and rewrote a short instruction for lithium treated patients, a book that kept coming in still new editions and in still new translations.

Mogens Schou was a modest and hardworking man, dedicated to serve his patients, his colleagues and his students. He was impatient, but he did not stop up before the manuscript he was working on was perfect, short and concise in elegant and correct English.

Mogens Schou died at the age of 87 - with a newly finished manuscript in his computer - a few days after returning home from a conference in Poland, where he had lectured. He was the father of modern lithium treatment and a pride for his colleagues and for his country. □