Thalidomide and phocomelia

THALIDOMIDE [alpha (N-phthalimido) glutarimide] is a synthetic drug with the structural formula shown in Figure 1. Thalidomide was invented by the firm of Chemie Grünenthal as a sedative, but when tested on animals was found to be ineffective. Chemie Grünenthal was, however, so certain that thalidomide must have some quieting effect on the central nervous system that it was then tested on man for its effect on epilepsy, and promptly reported to be useless as an anti-convulsant but an excellent sedative. By 1957, thalidomide, marketed under the trade-name of Contergan, was widely used as a sedative and for mental patients. It was considered "safe" to keep in the home because an overdose caused a sound sleep but never produced fatal poisoning. Thalidomide was added to other preparations for conditions where sedation would be beneficial, such as headaches (Algosedive, which is aspirin, phenacetin, and thalidomine), migraine, cough, asthma, gastrointestinal disturbances, grippe, arthralgia, and arthritis. A preparation with a small amount of thalidomide was sold as a tranquilizer. The rights to market the drug were sold to a number of foreign pharmaceutical firms, and the drug was exported to many other countries. Thus, to my certain knowledge, more than a dozen preparations have been placed on the market in a minimum of 16 countries, excluding the United States, where it was distributed to over 1,000 physicians for investigation. Table I gives a list of these drugs which the author has been able to check. Evidence is steadily accumulating which indicates that both the number of preparations and the number of countries is far in excess of the above figures.