The Drugs That Changed Our Minds

by Lauren Slater

  ‘It won’t work for you,’ she said. ‘The medications you’re on would block its effects.’

  Which would leave me no choice but to detox off a cabinet full of medicines in order to touch the sky. This is something I cannot do right now. I’m not willing to risk my sanity; I fought too hard for it. Given that ketamine does not require one to go off psychiatric medications, a ketamine clinic, of which there are two already in the metropolitan Boston area, might be the next stop.

  What, you might ask, am I really after here? It’s hard to express. It’s the fact that psychedelics, given in the right set and setting, offer the user a chance to know the universal, to step outside of time, to feel the hugeness of space and the deep interconnections among all beings. Psychedelics allow users to become more than conscious; they arrive at a whole new consciousness, their awareness as sharp as a shard of glass. I want that for myself. I’d like to really see the limits of my life, to feel my borders melt away, to swirl with space and view colours so fierce that they pulse, their hues truer than anything we normally notice. Given my particular set of circumstances, I don’t think I’ll have this opportunity in my lifetime, but as MAPS gets closer and closer to its goal of making psychedelics legal prescription drugs, many other people will. Who knows, there may come a day when a person with clinical depression turns to ketamine or psilocybin as a first line of treatment, with conventional antidepressants used only as a back-up. That would certainly be a paradigm shift.

  The 1950s and early 1960s were considered by many to be ‘the golden era of psychopharmacology’. Those decades saw the birth of chlorpromazine, which turned hurting heads inside out, all the screams and demons dumped on to the floor to be whisked away by a waiting nurse. Cade’s rediscovery of lithium finally gave those afflicted with mania and bipolar disorder a chance to live a more placid life. And then along came imipramine and the MAOIs, perhaps the most significant of all the drug discoveries of that time: finally we had chemicals that could weaken the grip of even the darkest depression, a disorder that 300 million people worldwide currently suffer from. Yes, for sure, the 1950s were rife with discoveries, each one made in some serendipitous fashion, chemicals for rocket fuel repurposed into psychic energisers – who would have thought?

  Once the 1950s were over, though, the discoveries dried up, with the bright exception of clozapine, a drug to treat schizophrenia, and the SSRIs, which Peter Kramer came to call cosmetic medicine, a drug that could dull the jagged edges of an irritable person, a drug not for the person but for the personality, a designer drug that could help people be bolder, more charming, more patient, nicer. Of course that’s not all the SSRIs did. Although they were and perhaps still are used abundantly for all sorts of minor ills, they also gave people like me a shot at a regular life, a life lived outside of institutions. But as we’ve seen, when compared with the tricyclics, the SSRIs were found to be no more effective in treating anxiety and depression, and they could also cause suicidal ideation. Meanwhile, they continue to be used in relative ignorance, as no one seems to know what their long-term side effects are. In other words, the holy grail has not been found.

  It could be, however, that psychedelics long used as sacred drugs in more shamanic cultures will bring us closer to what we are always seeking: peace of mind. These drugs are so powerful that they can actually cause love, as is the case with MDMA, which also appears to help autistic people – those locked in the box of their brain – enter into dialogue with the neurotypical world. Ayahuasca and psilocybin both have proven to be very effective at treating addictions, as these psychedelics allow substance abusers to powerfully experience just what their behaviour is doing to them and those within their circle. There is more than a little irony in the fact that psychedelics, considered evil and dangerous drugs by government agencies, can help addicts relinquish highly addictive chemicals such as opium-based concoctions like heroin and fentanyl, the very bogeymen at the centre of our ill-conceived ‘War on Drugs’.

  Our next golden era of psychopharmacology, I predict, will be with psychedelics, drugs not discovered but rediscovered, drugs so pure and powerful that they crack the thin veneer we call reality and show us a show the likes of which we do not forget. Psychedelics may be more potent in treating many psychiatric disorders than anything we have right now, and in some strange way they reunite us with the father of psychoanalysis, Sigmund Freud, who believed that awareness was the vehicle by which we could be cured of our ills. At once brand-new and ancient, psychedelics allow us a radical awareness of our place and purpose in the universe; they actually seem to set us straight, these tie-dye drugs of long-gone hippiedom.

  Thus it may be that we need to get high in order to finally act right. I hope, however, that we do not go so far as to forget the men and women who found the first cures, even if they have turned out to be radically less than perfect. The drugs presented in this book all have their flaws, for sure. But they all, in one manner or another, have helped numerous people to live a life, and that’s no small thing. Even if the price has been steep, and the side effects sometimes severe, nevertheless the first golden era gave people back their minds and their days, long hours of light and water, serenity in the gaps where there used to be screeches, with the possibilities pure and seemingly endless, at least for a little while.

  Acknowledgements

  Thanks go to my editor at Little, Brown, Ben George, for seeing me the whole way through, for pulling this book up by its bootstraps and, to mix my metaphors here, hand-planing its many rough edges, doing the long, hard work of an editor with a vision and a belief, so much so that I feel the product comes not from me but from a joint effort, although any mistakes, soft spots, brown spots or rust ridges are mine and mine alone.

  I could not have even conceived of this book were it not for my extraordinary agent, Dorian Karchmar, who heard, one day, five years ago, the delicate thrum of an idea and from that thrum pulled out a whole soft skein that came to be called ‘the proposal’. I have written eight other books and seven of them were born on the backs of proposals, but no one has ever guided me from the first stray glitters of an unformed notion to a whole exposition of ideas and structure, and done it so patiently and insistently, so calmly and forcefully – for this I am deeply indebted.

  Anna Jaffe read early drafts of this book and gave me the confidence to go on when I felt I could not. Alberta Nassi provided similar support. My children, while involved in no explicit way, nevertheless gave me motivation, because they were living proof that I am capable of producing at least two beautiful beings, and thus my manuscript stood a slim chance. A book, of course, is not a human, but still, if it is any good, it has a heart, and legs too; a book should skip and beat and, if it’s really doing its job, it should exert some force upon your heart, the reader’s heart, and thus I have, as well, to thank you, the reader, for putting these pages in your palm, or on your tablet, or wherever they may be. It is a great honour to be held in such a fashion. I hope I can return the favour.

  Also by Lauren Slater:

  Playing House: Notes of a Reluctant Mother

  The $60,000 Dog: My Life with Animals

  Blue Beyond Blue: Extraordinary Tales for Ordinary Dilemmas

  Opening Skinner’s Box: Great Psychological Experiments of the Twentieth Century

  Love Works Like This: Travels Through a Pregnant Year

  Lying: A Metaphorical Memoir

  Prozac Diary

  Welcome to My Country: A Therapist’s Memoir of Madness

  Notes

  1. Chlorpromazine

  Sea change in policy regarding mental health treatment: Steven J. Taylor, ‘Caught in the Continuum: A Critical Analysis of the Principle of the Least Restrictive Environment’, Research and Practice for Persons with Severe Disabilities 29 (2004): 218–30.

  History of treatments preceding chlorpromazine: Elliot Valenstein, Great and Desperate Cures (New York: Free Press, 1988), 15–20.

  Manfred Sakel coma therapy: David Heal
y, The Creation of Psychopharmacology (Cambridge, MA: Harvard University Press, 2004), 52–53.

  Depth of hypoglycaemic comas: Heinz Lehmann and Thomas Ban, ‘The History of the Psychopharmacology of Schizophrenia’, Canadian Journal of Psychiatry 42 (1997): 152.

  Meduna experiments: Ibid.

  Lucio Bini’s use of electroconvulsive therapy: Norman S. Endler, ‘The Origins of Electroconvulsive Therapy (ECT)’, Convulsive Therapy 4, no. 1 (January 1988): 5–23.

  Lehmann’s use of fever in treatment: Maureen Muldoon, ‘From Psychiatrist-Researcher to Psychiatrist and Researcher: Heinz Lehmann’, Journal of Ethics in Mental Health 6 (2011): 222.

  Moniz, the invention of psychosurgery: Healy, The Creation of Psychopharmacology, 40–41. See also Mical Raz, The Lobotomy Letters: The Making of American Psychosurgery (Rochester, NY: University of Rochester Press, 2013), 5–7.

  The doctor-turned-pilot and the virtuoso violinist: Jack El-Hai, The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness (New York: Wiley, 2005), 196, 277.

  Use of an ice pick in the first lobotomy: Jenell Johnson, American Lobotomy: A Rhetorical History (Ann Arbor: University of Michigan Press, 2014), 24.

  Chemical make-up of chlorpromazine: Healy, The Creation of Psychopharmacology, 80–81.

  Methylene blue protects against Alzheimer’s: H. Atamna and R. Kumar, ‘Protective Role of Methylene Blue in Alzheimer’s Disease via Mitochondria and Cytochrome C Oxidase’, Journal of Alzheimer’s Disease 20, no. 2 (2010): 439–52.

  Methylene blue staining nerve cells of frogs: Healy, The Creation of Psychopharmacology, 44.

  Treating neuralgia with methylene blue: Ibid.

  Pietro Bodoni treating manic patients with methylene blue: Ibid.

  Methylene blue transformed into chlorpromazine: Ibid., 39.

  ‘no drug company would market an old drug even if it worked’: Ibid., 45.

  ‘competing therapies or interest groups’: Ibid., 44–45.

  Phenothiazine nucleus having antihistamine effects: Judith Swazey, Chlorpromazine in Psychiatry: A Study of Therapeutic Innovation (Cambridge, MA: MIT Press, 1974), 58.

  Promethazine synthesised in 1947: Ibid., 77.

  Promethazine precursor to chlorpromazine: Ibid., 78.

  The sinking of the Sirocco: Henri Laborit, L’esprit du grenier (Paris: Grasset, 1992), 103–53.

  Laborit’s use of promethazine: Fernando Alemanno and Ferdinando Auricchio, ‘Sedation in Regional Anesthesia’, in Anesthesia of the Upper Limb: A State of the Art Guide, eds. Fernando Alemanno, Mario Bosco and Aldo Barbati (New York: Springer, 2014), 233.

  Artificial hibernation and Laborit’s use of promethazine: Swazey, Chlorpromazine in Psychiatry, 62.

  ‘euphoric quietude’: Laborit in La Presse Médicale (1950), cited ibid., 79.

  ‘tense and anxious Mediterranean type’: Ibid.

  Description of surgical shock: Ibid., 62.

  Courvoisier and Charpentier test discoveries: Healy, The Creation of Psychopharmacology, 82.

  ‘a completely different molecule’: Ibid., 81.

  Pierre Koetschet on the usefulness of chlorpromazine: Swazey, Chlorpromazine in Psychiatry, 96.

  ‘The idea of an antipsychotic’: Healy, The Creation of Psychopharmacology, 84.

  Laborit’s ‘lytic cocktail’: Ibid., 79.

  Chlorpromazine included in soldiers’ battlefield kits: Ibid., 82.

  ‘possible use of the product in psychiatry’: Swazey, Chlorpromazine in Psychiatry, 106.

  Quarti’s account of chlorpromazine’s effects: Ibid., 117–18.

  Treatment of Jacques Lh.: Ibid., 119–20.

  Jean Delay’s reputation: David Healy, The Psychopharmacologists, vol. 1 (Boca Raton, FL: CRC Press, 4 September 1998), 2.

  Patients given rectal enemas: Jean Thuillier, Ten Years That Changed The Face of Mental Illness (Boca Raton, FL: CRC Press, September 1999), 5.

  Woman getting second-degree burns in the bath at Sainte Anne’s: Ibid.

  Sigwald and Bouttier: Swazey, Chlorpromazine in Psychiatry, 126.

  Madame Gob: D. G. Cunningham Owens, A Guide to the Extrapyramidal Side Effects of Antipsychotic Drugs (New York: Cambridge University Press, 1999), 7.

  Hamon’s results: Ibid., 112.

  Delay and Deniker first learned of chlorpromazine: Owens, A Guide to the Extrapyramidal Side Effects of Antipsychotic Drugs, 7.

  The case of Phillippe Burg: Healy, The Creation of Psychopharmacology, 91.

  Responses to chlorpromazine of catatonic patients versus paranoid patients: Elliot Valenstein, Blaming the Brain: The Truth about Drugs and Mental Health (New York: Free Press, 1988), 25.

  The barber’s reaction to chlorpromazine treatment: Healy, The Creation of Psychopharmacology, 91.

  The barber shaves the psychiatrist: Ibid., 93.

  Account of the juggler’s reaction to chlorpromazine treatment: Ibid., 91.

  Jean Thuillier to the fish dealer: David Healy, The Psychopharmacologists, vol. 3, 3rd ed. (Boca Raton, FL: CRC Press, 2000), 551.

  Glaziers’ work reduced: David Healy, The Antidepressant Era (Cambridge, MA: Harvard University Press, 1997), 63.

  Laborit suggests Largactil as name: Swazey, Chlorpromazine in Psychiatry, 141.

  Smith, Kline & French’s marketing: Valenstein, Blaming the Brain, 141.

  Smith, Kline & French’s response to Rhône-Poulenc’s inquiry: Ibid., 160.

  Difficult to get chlorpromazine into North American treatment programmes: Swazey, Chlorpromazine in Psychiatry, 196.

  Henry Brill on resistance to chlorpromazine: Ibid.

  ‘No one in his right mind was working with drugs’: Ibid., 196–97.

  Patients would have taken the two years of restored life: Healy, The Creation of Psychopharmacology, 97.

  ‘One of them would even rip radiators right off the wall’: R. Walter Heinrichs, In Search of Madness (New York: Oxford University Press, 2001), 151.

  A clean somatic approach: Swazey, Chlorpromazine in Psychiatry, 217.

  ‘That was perhaps the most spectacular demonstration’: Ibid., 201.

  ‘Lest everything be evaluated in terms of decibels’: Ibid.

  Mortgaging his house to buy shares of chlorpromazine: Healy, The Creation of Psychopharmacology, 98.

  Within a year chlorpromazine had been prescribed: Sarah Linsley Starks and Joel T. Braslow, ‘The Making of Contemporary American Psychiatry, Part 1: Patients, Treatments, and Therapeutic Rationales Before and After World War II’, History of Psychology 8, no. 2 (May 2005): 181.

  The patient populations in asylums: Swazey, Chlorpromazine in Psychiatry, 222.

  Ayd’s patient dismissed as ‘hysterical’: Healy, The Creation of Psychopharmacology, 110.

  Parkinson’s seen as repressed anger: Ibid., 112–13.

  Naming and history of the double-bind theory: Gregory Bateson, Don D. Jackson, Jay Haley and John Weakland, ‘Toward a Theory of Schizophrenia’, Systems Research and Behavioral Science 1, no. 4 (1956): 251–64.

  Acetylcholine given to schizophrenic patients: Edward Shorter, A History of Psychiatry (New York: Wiley, 1988), 247.

  Chemical versus electrical signalling: Elliot Valenstein, The War of the Soups and the Sparks (New York: Columbia University Press, 2005), 3.

  An alkaloid from the Rauwolfia plant: Healy, The Creation of Psychopharmacology, 102.

  Bowman invented a machine called the spectrophotofluorometer: Victoria A. Harden, Ph.D., and Claude Lenfant, M.D., ‘The AMINCO-Bowman Spectrophotofluorometer’, Stetten Museum Office of NIH History, Web.

  Brodie used the new machine: Healy, The Creation of Psychopharmacology, 106.

  Rabbits became lethargic, apathetic: Scott Stossel, My Age of Anxiety (New York: Knopf, 2013), 174.

  Arvid Carlsson discovering that dopamine: Vikram K. Yeragani, ‘Arvid Carlsson, and the Story of Dopamine’, Indian Journal of Psychiatry 52 (2010): 87–88.

  The ‘dopamine hypothesis of schizo
phrenia’: Ralf Brisch et al., ‘The Role of Dopamine in Schizophrenia from a Neurobiological and Evolutionary Perspective: Old Fashioned, but Still in Vogue’, Front Psychiatry 5 (2014): 47.

  Schizophrenics experiencing obstetrical trauma at birth: J. R. Geddes et al., ‘Schizophrenia and Complications of Pregnancy and Labor: An Individual Patient Data Meta-Analysis’, Schizophrenia Bulletin 25, no. 3 (1999): 413–23.

  Schizophrenia caused by an error: Edward Shorter, A History of Psychiatry, From the Era of the Asylum to the Age of Prozac (New York: Wiley, 1988), 270.

  Neurons were jumbled: Ibid., 268.

  PET and fMRI technology: Ibid., 269.

  In 2011, atypical antipsychotics were prescribed: Richard A. Friedman. ‘A Call for Caution on Antipsychotic Drugs’, New York Times, 24 September 2012.

  ‘their psyches manipulated by therapists’: Healy, The Creation of Psychopharmacology, 148.

  The drug has been relegated: E. Estrada, ‘Clinical Uses of Chlorpromazine in Veterinary Medicine’, Journal of the American Veterinary Medical Association 128 (1956): 292–94.

  ‘When it comes to antipsychotics’: Personal interview with Alexander Vuckovic, 19 February 2015.

  Hiroshi Utena pushed out of his office: Jon Agar, Science in the 20th Century and Beyond (Malden, MA: Polity Press, 2012), 243.

  Students in France storming Sainte-Anne’s asylum: Ibid.

  The ransacking of Jean Delay’s office: Healy, The Creation of Psychopharmacology, 176–77.

  Spiders under the influence of hallucinogens: Ronald K. Siegel, Intoxication: Life in the Pursuit of Artificial Paradise (New York: Park Street Press, 1989), 73.

  2. Lithium

  Lithium found in space: Michael Pidwirny, Understanding Physical Geography (Kelowna, BC: Our Planet Earth Publishing, 2015), 3.

  The element atomises on contact with air: Jaime Lowe, ‘I Don’t Believe in God, but I Believe in Lithium’, New York Times, 25 June 2015.