In 1987, Eli Lilly and Company was given the green light by the government to begin marketing a new antidepressant drug called fluoxetine, better known as Prozac. By 1990, Prozac was the most prescribed antidepressant in the US, with 650,000 prescriptions per month and Lilly’s sales topping $1 billion dollars. Prozac was the catalyst for a psychopharmaceutical boom of SSRI’s (selective serotonin reuptake inhibitors) to treat depression. Following Prozac were drugs like Luvox, Paxil, Lexapro. Then came the atypical antidepressants, such as Wellbutrin, Cymbalta and Remerona. By 2008, 11 percent of people in the US were taking at least one of the dozens of brand-name antidepressants. Shockingly, for women in their 40’s and 50’s that percentage was about 25%.
Clearly these new drugs have had some positive effect on depression and depression-related disorders. But the psychoactive drug industry is not perfect. Often, psychoactive drugs are later found to have significant side effects or cause future medical issues. We have all heard that if we don’t learn history we are doomed to repeat it. Hopefully that is not the case with the research required of psychoactive drugs today, but it is worth understanding how we treated depression and other mental disorder prior to the medical breakthroughs of the 70’s and 80’s.
Opium, Heroin and Cocaine
Opium has been used across the world as a pain reliever since the 4th millennium BCE, becoming part of American pharmaceuticals in the late 18th century. By the 1880’s, opium was by far the most popularly prescribed drug for physical and emotional pain. Opium was prescribed for nearly everything we prescribe Tylenol or Advil for today, recommended by physicians and advertised widely across medical journals and the popular press. It was easily purchased without a prescription from local pharmacies and even general stores. In the 19th century it was considered an excellent treatment for a catch-all disorder called “Americanitis,” a condition brought on by the increasing hustle and bustle of the new American way of life.
Morphine was considered superior to opium as it was stronger and injectable. It was even considered a treatment for opium addiction. Opium and morphine were considered the lady’s drug of choice, and were often prescribed for “women’s troubles,” from menstrual problems to childbirth pain. However, besides treating pain, women considered these drugs as a great escape from daily life, taken by ladies of distinction who had no professions. By 1900, it is believed that over four percent of the population was addicted to opiates, and the medical community was taking notice of this issue. In 1898, heroin was brought on the scene to fight morphine addiction, amongst other uses. The turnaround for heroin was much quicker; by 1913 Bayer stopped making it. In the meantime, Sigmund Freud began writing about cocaine, which he had been experimenting with on himself. Produced by Parke, Davis & Company, cocaine infatuation was quickly underway in American and Europe. Yet again, cocaine’s addictive properties quickly became known, and cocaine became associated with the lower orders of society, as opposed to the polite society that these drugs had been associated with previously. Gradually, beginning in the early 20th century, laws were put into place to regulate these drugs, creating the underground drug trade for these drugs that continues today.
Amphetamines and Barbiturates
The 1930’s saw a rise in uppers and downers in the form of barbiturates and amphetamines. As the drugs that came before them, both were praised as safe, effective and non-addictive. Barbiturates became used for intravenous anesthetics, as well as for pain relief, seizure control, ulcers, migraines and asthma. However, the biggest selling point for barbiturates was the euphoric feeling they produced. Therefore the drugs soon acquired a reputation as a good drug to soothe the American psyche, and became a great ally to psychotherapists and psychiatrists. The barbiturate Amytal was used in therapy to relax the fears and anxieties of the client. However, the dangers of barbiturates also became known. They were habit forming, had dangerous side effects and little room for dosing error as people began to see deaths from overdose.
Although amphetamines arrived sometime later, they became very popular very fast and shot to the top of the market as barbiturates were still being used. Amphetamines had a curiously enlivening effect on the brain, making people focused and productive, as well as social and happy. Although there were a lot of trials to see what conditions amphetamines could treat, it was quickly found that amphetamines could help with narcolepsy and Parkinson’s disease as well as calming unruly kids. Today, amphetamines are still used extensively to treat ADD/ADHD. Recently, amphetamines have also become popular in treating depressive symptoms of fatigue and lack of interest, called anhedonia. Unfortunately, as with all psychoactive medications, this drug has also found misuse in the diet industry and among college students wishing to stay awake and cram for tests.
Since doctors had the choice of barbituates for calming people down, when the first tranquilizer was produced in 1951 there was little interest. However, as psychiatrists slowly began to use tranquilizers on their anxious patients they reported that it worked wonders. Tranquilizers made made people less tense and irritable and more productive and relaxed during the day. In addition, tranquilizers seemed to offer a good night’s sleep without the side effects, addictive properties, and risk of death from barbituates. Slowly, over the mid to late 1950’s tranquilizers became very popular to treat a variety of conditions. By 1978, a favorite tranquilizer called Valium made a billion dollars for it’s company Roche. Valium became a favorite amongst tranquilizers, especially amongst women. Today, newer tranquilizers such as Klonopin, Ativan and Xanax are still widely prescribed to treat anxiety disorders, sleep problems and other nervous conditions.