Science is full of lucky whoopsies, and psychiatric medication has more than its share. From incredibly wrong-headed ways to keep people from masturbating to making TB patients dance, here’s how we (accidentally) got the modern pharmaceutical industry.
During the 1800s, masturbation was considered as a way to induce everything from epilepsy to round shoulders. Doctors and parents would go to any length in order to curb the carnal behavior. That resulted in a lot of pain and suffering but, as with almost any kind of experimentation, it yielded some useful results.
The first was potassium bromide. Potassium bromide got shoved into unsuspecting people’s throats because it looked a lot like iodine: reddish and smelly. But, while iodine could actually be used to treat syphilis, bromine (which could be harvested from seawater and so was relatively easy to get) was poisonous and burned the throat on its way to killing a person. But combining bromine with potassium made it bearable, and people thought that perhaps it would treat syphilis the way iodine did. It did not.
What it did, according to Charles Lockock who took note of patients being treated with potassium bromide and wrote up his findings in The Lancet in 1857, was stop people from masturbating. This, again according to Lockock, helped treat their epilepsy, since epilepsy was believed to be the result of chronic masturbation. Twelve years later, potassium bromide was joined by chloral hydrate as another anti-masturbatory agent. Doses of these drugs would keep patients calm and relaxed, and eventually send them off to sleep without so much as lifting a finger. Over the years, the emphasis on preventing masturbation eased up, but both drugs are still used occasionally to calm people, to sedate them, and to prevent convulsions. Chloral hydrate is also still used as a hypnotic.
Lithium and thorazine are two of the most important psychiatric medications in history. They changed what people thought psychiatric medication was capable of, and freed people who otherwise might have spent their lives in overloaded asylums, unable to function. And they were both invented by people who had no idea what they were working towards.
Bipolar disorder wasn’t always called bipolar disorder. Back in the late 1800s, it was called mania, and people thought that it was possible to cure the disorder with the right diet. This wasn’t as crazy as it sounded. Gout, an inflammation of the joints, was often caused by a meat-and-wine rich diet, and it put people in both depressed and manic moods. When chemists got involved, they noted that people with “mania” had high levels of uric acid in the blood, and gout was caused by high levels of uric acid in the blood.
What breaks down uric acid is lithium carbonate. Unfortunately, lithium carbonate can also easily kill people if they are given the wrong dose. This is part of the reason why the use of lithium carbonate to treat mania and depression got raised and dropped many times over the next sixty years. In the 1940s, John Cade tried other ways to treat mania, by finding other ways of cutting down uric acid in the blood, and found that they were completely useless. For the first time, scientists realized that it was the lithium itself that was making the difference. Lithium became, and still is, one of the major medications used to treat bipolar disorder.
Elsewhere in the 1940s, Dr. Henry Lavorit thought that perhaps suppressing the body’s alarm response might help his patients get through surgery. He witnessed the suppression of the body’s alarm-system in antihistamines, the drugs that suppressed allergic reaction. He came up with a drug called chlorpromazine, an antihistamine, which he gave to people who were nervous about their impending surgeries. Their nervousness took a nosedive, but so did their blood pressure. The drug was impossible for surgical patients. Lavorit took it to mental asylums as a possible sedative. At the time, the only way to deal with schizophrenic patients was to sedate them to near-comatose levels. A few weeks, and sometimes even days, on Lavorit’s medicine, and patients that had been given up for lost were calm, rational, alert, and ready to enter the world again.
And then there are the medications that were regularly injected into people in the hopes they would do one thing, and then were found to do another. Chief among these are two famous mood-altering medications. The first was called mephenesin. It was not a medication itself. It was meant as a way of preserving a medication—in this case penicillin. Scientists found, whenever they injected lab mice with this (presumably very old) penicillin, the rats became calm and lethargic, unafraid of getting the next needle jab. They decided to try to get the same reaction from people, and mephenesin became Miltown, the first anti-anxiety drug.
Other companies chased the success, and the profits, of Miltown. La Roche laboratories didn’t have a penicillin preservative, but they did have a dye meant for staining biological tissue. When this was injected into lab rats, they also became calm and sluggish. This dye went on to become diazepam—better known as valium.
And then there was iproniazid. Iproniazid was an attempt by La Roche laboratories to catch up to a competitor’s innovation. Isoniazid had been a fantastically successful tuberculosis drug at a time when the world really needed tuberculosis drugs. Getting tuberculosis was, in the early 20th century, what getting cancer is now. While it wasn’t a death sentence, it was a dangerous and often relapsing disease that required months or even years of treatment at special facilities. One of those facilities, Sea View Tuberculosis Hospital, got a load of iproniazid from Roche in 1952. The patients failed to improve, but instead of lamenting their lack of improvement, they became animated and happy. Some even started dancing around. The drug was the first MAO inhibitor, and the very first antidepressant.
Today, drug companies use this very technique, slightly altering the formula of a drug and seeing what it does in order to find new medications. There are relatively few accidental psychiatric drug discoveries. Or maybe we’re due for another happy accident.