"Anatomy of an Epidemic" Part 2: The Origins of Psychopharmacology

The modern day view of science conjures up almost godlike images of mastery over the physical world. Particularly in the area of medicine, we like to think that for any given ailment, we have a drug that will cure it. The reason we think this is that it is actually true, in some but not all cases. Antibiotics can cure bacterial infections; the polio vaccine has damn near eradicated polio from the planet; pain relievers can do a very good job at helping people manage pain even though they don't cure it. So there are good medicines out there that are clearly beneficial.

Modern day psychiatry is saying they can do the same thing. Feeling a little down? Cure it with this SSRI. Having problems focusing? No problem, how about some ritalin. The problem is that while psychiatry and the pharmaceutical companies want you to believe that these are "magic bullets," and that they understand exactly their long term impact on the brain, they really don't. They basically know that there are three chemicals that affect the functioning of the brain: serotonin, dopamine, and norepinephrine. But how these all interact to produce memory, emotion, ethics, behavior, instinct -- in short, YOU -- they really have no idea. They claim that because 28% of depressed people had low serotonin levels in a study that boosting serotonin levels will cure depression. Nevermind that 25% of the normal control group also had similarly low serotonin levels. But I'm getting ahead of myself. That is for part three which will be about the theory of chemical imbalances in the brain.

The point is, these drugs are not cures. They exhibit certain effects whose ultimate impact are not entirely understood. They also burden the user with uncomfortable side effects, and then later agonizing withdrawal should the user decide to stop. The users of antidepressants are quite literally addicts, and Effexor is one of the worst, if not THE worst to come off of because of it's relatively short half life of around 20 hours (vs Prozac which has a half life of 1-7 days, depending).

Psychopharmacology would like you to think that these drugs were all carefully tailored and engineered specifically for the intended purpose. This isn't really true.

Thorozine, the drug that started it all, was originally discovered when searching for a cure for malaria. When that didn't work, they found it had antihistamine and possibly anesthetic properties. They began testing it in surgery and Henri Laborit noticed it could be used in psychiatry.

This new drug, chlorpromazine [marketed as Thorozine in the U.S.], apparently disconnected brain regions that controlled both motor movement and the mounting of emotional responses, and yet did so without causing the rats to lose consciousness.

...

Although today we think of lobotomy as a mutilating surgery, at that time it was regarded as a useful operation. Only two years earlier, the Nobel Prize in Medicine had been awarded to the Portuguese neurologist, Egas Moniz, who had invented it. The press, in its most breathless moments, had even touted lobotomy as an operation that plucked madness neatly from the mind. But what the surgery most reliably did, and this was well understood by those who performed the operation, was change people in a profound way. It made them lethargic, disinterested, and childlike. That was seen by the promoters of lobotomy as an improvement over what the patients had been before -- anxious, agitated, and filled with psychotic thoughts -- and now, if Laborit was to be believed, a pill had been discovered that could transform patients in a similar way.

Anatomy of an Epidemic, page 49

Physicians in the United States similarly understood that this new drug was not fixing any known pathology. "We have to remember that we are not treating diseases with this drug," said psychiatrist E. H. Parsons, at a 1955 meeting in Philadelphia on chlorpromazine. "We are using a neuropharmacologic agent to produce a specific effect."

Anatomy of an Epidemic, page 50-51

Next was Miltown, a minor tranquilizer that was discovered while trying to discover a compound that would kill gram-negative bacteria, and started development by researching the commercial disinfectant called Phenoxetol. This was eventually synthesized into meprobamate and sold for human consumption.

An article published in the Science News Letter ... put the animal experiments into a human frame of reference. If you took a minor tranquilizer, he explained, "this would mean that you might still feel scared when you see a car speeding towards you, but the fear would not make you run."

Anatomy of an Epidemic, page 52-53

By the spring of 1957, the first antidepressant, iproniazid, was brought to market as Marsilid. It's source? A Nazi Germany substitute for rocket fuel called hydrazine. It was originally used to treat TB (Tuberculosis) patients, but seemed to also act as a "psychic energizer."

Iproniazid was seen as having the greater potential, but initial tests did not find it to be particularly effective in lifting spirits, and there were reports that it could provoke mania. Tuberculosis patients treated with iproniazid were also developing so many nasty side effects -- dizziness, constipation, difficulty urinating, neuritis, perverse skin sensations, confusion, and psychosis -- that its use had to be curtailed in sanitariums.

Anatomy of an Epidemic, page 53

So there you have it. The drugs that launched the Psychopharmacology revolution were originally intended to treat malaria, gram negative bacterial infections, and TB, but were then used to induce certain psychological effects in humans. It seems clear that the developers did not fully understand the full long term implications of the drugs they were issuing and that trend seems to persist today.

I guess the bottom line is, if you knew your antidepressant was derived from rocket fuel... would you take it?