Coramine

 

Coramine

 The Controversial Respiratory Stimulant That Faded Away

By Farouk Alam

Once hailed as a miracle revival drug, Coramine—also known as nikethamide—was a central nervous system stimulant widely used in the mid-20th century. Administered to treat respiratory depression and to revive patients from anesthesia or fainting episodes, this drug enjoyed a prominent place in emergency kits and hospital wards across the world. But its reputation was not built to last.

What Is Coramine?

Chemically known as nikethamide, Coramine is a derivative of nicotinamide. It was primarily used as a respiratory and circulatory stimulant, particularly during or after anesthesia. Doctors would often inject it intravenously or intramuscularly to “wake up” patients who were struggling to breathe or slipping into unconsciousness.

It stimulated the medullary respiratory centers of the brain, encouraging the body to inhale more deeply and rapidly, boosting oxygen levels and circulation.

A Popular Revival Agent

In the 1940s through the 1960s, Coramine was often considered a go-to drug for resuscitation. It was also used by athletes and soldiers to enhance performance and overcome fatigue—especially during World War II. Some even believed it could sharpen mental clarity or revive people after fainting spells.

Its availability over the counter in some countries and dramatic appearances in old movies—where a quick jab of Coramine seemingly brought people back from the brink—contributed to its mystique.

The Controversy

Despite its popularity, Coramine's effectiveness was never fully supported by rigorous scientific evidence. Over time, researchers began questioning its efficacy, particularly in serious respiratory failures. More concerning, its use was linked to seizures, convulsions, and other neurological side effects when administered in higher doses.

By the 1980s, most developed countries had withdrawn or restricted its use. The World Health Organization no longer lists it as an essential medicine. It was deemed obsolete and potentially dangerous when better alternatives—like oxygen therapy, modern anesthetics, and specific CNS stimulants—became available.

Legacy and Lessons

Today, Coramine is largely a relic of medical history. It is still manufactured in some countries, but it is rarely prescribed or used in clinical settings. Its story serves as a reminder of how medical practices evolve, and how drugs once seen as life-saving can fall out of favor when subjected to deeper scientific scrutiny.

It also highlights the importance of evidence-based medicine: just because a treatment appears to work anecdotally or in emergencies doesn’t mean it stands the test of scientific rigor.

Final Thoughts

Coramine's journey from hero to has-been illustrates the fast-changing landscape of medicine. While it once symbolized the triumph of pharmaceutical science, its decline is a cautionary tale of misplaced faith and the risks of using stimulants without solid understanding. In an age of medical transparency and accountability, the story of Coramine urges us to continually question, study, and refine the tools we use to heal.