Protecting mental health in the Age of Anxiety: The context of Valium's development, synthesis, and discovery in the United States, to 1963

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2009-01-01
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Guise-richardson, Catherine (cai)
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Alan I. Marcus
Hamilton Cravens
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Abstract

This dissertation draws out various facets of the conditions preparing and situating Valium as a marketable substance and cultural entity. It offers one explanation for the widespread prescription and use of Valium in the 1960s.

The post-World War II conceptualization of mental health and illness as a spectrum, with the majority of Americans falling between the poles and therefore either neurotic or at risk, heightened interest in mental health. Increased availability of health insurance brought more Americans to their physicians. National programs - establishment of the National Institutes of Mental Health, the Hill-Burton Act, and formation of a Joint Commission on Mental Illness and Health through the 1955 Mental Health Study Act - recognized widespread support for programs to increase the number of mental health practitioners and facilities focused on neuroses, personality disorders, and outpatients in general. Popular theories, including Walter Cannon's homeostasis and Hans Selye's General-Adaptation-Syndrome, promoted the idea that stress, and response to it, were among the most important aspects of health. The American public increased its demands for mental health services. Interplay between these conditions promoted use of psychopharmaceuticals. They were quick to prescribe and therefore allowed doctors to see more patients each day. They somaticized mental illness, bringing it within the boundaries of traditional medical insurance coverage. They did not cure an illness; they reduced symptoms and therefore either allowed the body to recover, or in an ongoing fashion prevented immature personalities from reaction to stresses in a manner leading to more serious medical problems.

In the 1950s, it became possible to screen chemicals for a tranquilizer. The expense of creating and treating experimental neuroses in animals to screen chemical compounds was prohibitive. Yet these experiments informed pharmacologists; they could identify antineurotic or tranquilizing drugs through physical manifestations. With availability of antibiotics, pharmaceutical industries could keep fairly healthy populations of mice, rats, cats, and monkeys for testing. Chlorpromazine's discovery and introduction into institutional psychiatry, around 1953, set out the basic features defining a tranquilizer. By 1958, pharmacologists had the ability and expectations required to inject a mouse with diazepam, check if it rolled off an inclined screen and, observing the tumbling rodent, recognize the ingested molecule was a potentially marketable tranquilizer.

Valium's development and discovery took place when tranquilizers were new and held out promise as mental health prophylactics, mild sedatives, and safe hypnotics. Mild mental illness needed rapid, effective, and fairly inexpensive treatment. Faced with patients undergoing severe or ongoing stress, doctors turned to anxiety-reducing drugs in order to prevent psychosomatic mechanisms resulting leading to any of a dozen physical illnesses. Compared with earlier alternatives - barbiturates, alcohol, major tranquilizers - Valium was safe, nonaddicting, and had few if any dangerous side effects.

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Thu Jan 01 00:00:00 UTC 2009