Chapter 11 One of the ways that governments attempt to control drugs is to require medical prescriptions for their purchase and distribution Most pharmaceutical drugs roughly 8 out of 10 have no psychoactive effect whatsoever they are prescribed exclusively to treat bodily ailments such as heartburn high blood pressure high blood sugar and asthma All brand name drugs decline in sales after their peak in popularity and for several reasons The fi rst is that the patent held by the pharmaceutical company that initially markets a prescription drug is valid for only 20 years from the time of fi ling and it may take as many as 10 years for the drug to reach the market A second reason nearly all psychoactive prescription drugs decline in popularity over the long run is that physicians become aware of some of their undesirable side effects and search for less toxic substances Sedative Hypnotics An Introduction laudanum Some of us are often too anxious and agitated to be capable of properly functioning some of us are even too troubled to fall asleep at night Sedatives or sedativehypnotics are downers or general depressants they retard dull or obtund signals passing through the central nervous system The sedative tranquilizer hypnotic dimension is a spectrum or continuum the precise point along this dimension that defi nes a substance s action is determined by the dose taken rather than the specifi c drug used In the 1600s a chemist dissolved opium powder in alcohol thereby inventing a 10 percent solution seemed to be about the right mixture to produce in most patients a sleep inducing effect without causing serious damage In mixing up this concoction chemists had devised a narcotic to serve as a sleep aid However laudanum s soporifi c properties also brought on in some patients addiction along with night terrors In the 1840s chemists discovered the calming effect of potassium bromide and the drug became popular for several generations However the side effects of this substance included depression discoordination lethargy a loss of concentration and memory tremors and sometimes delirium and heart ailments In the 1860s a German chemist discovered and published a scientifi c paper on the sedative properties of a recently developed substance named chloral hydrate It immediately found its way into clinical medicine for this very purpose being touted as the only safe hypnotic sedative But soon after it was introduced as a pharmaceutical patients began experiencing undesirable side effects slurred speech confusion vomiting an involuntary loss of consciousness amnesia anesthesia sometimes convulsions even coma Recreational use soon became fashionable among poets writers and painters apparently some daring risk taking adventurous members of the avantgarde enjoyed that hazy luminous twilight state that the substance induced Criminals and other shady characters discovered that chloral hydrate when introduced into an alcoholic drink served well as a knockout drop thus the Mickey Finn was born Barbiturates Barbiturates are defined as central nervous system depressants that are derived from barbituric acid Barbital the fi rst barbiturate was marketed under the brand name Veronal After Veronal was commercially introduced in 1903 the medical use of chloral hydrate the sedative supreme with the many distressing side effects shrank into near oblivion Barbiturates are classified according to the speed of their action The ultra shortacting barbiturates include Brevital Surital and pentothal truth serum They are administered IV and produce unconsciousness and anesthesia within a minute and their effects last two or three hours The short and intermediate acting barbiturates are used for sedation and as sleep aids they include Tuinal known on the street as tooies rainbows or Christmas trees Seconal or secobarbital sekkies seggies reds or red devils Nembutal yellow jackets nimmies or nimbies Fiorinal and Amyta or amobarbital ammies The long acting barbiturates include Luminal or phenobarbital and mephobarbital Mebaral they are used as anti anxiety agents as well as anti epileptic drugs do not produce a high are rarely used recreationally and need not be discussed here Except as sedatives barbiturateshave been replaced by the benzodiazpam drugs which physicians regard as much safer In terms of their effects the barbiturates are remarkably like alcohol alcohol is sometimes referred to by pharmacologists as a liquid barbiturate It ispossible to die of barbiturate withdrawal whereas death from withdrawal from the narcotics is quite rare Methaqualone Aka Qua a lude Was developed as a nonaddicting alternative to barbiturates at fi rst scientists and physicians thought the drug was not habit forming and produced no ataxia discoordination or mental clouding and no overdoses Alas the doses whose effects researchers originally observed were unrealistically small at larger doses the same harmful side effects as with barbiturates appeared In fact in the 1970s the press seized upon methaqualone partly as a result of its alleged sex drug properties and partly because of a few much ballyhooed overdoses and so it became the most notorious drug of the 1970s Methaqualone is currently considered so problematic that it is never prescribed even its recreational use has fallen into semioblivion Benzodiazepines The benzodiazepines are the Valium type tranquilizers Initially released in 1963 between 1969 and 1982 Valium was the most frequently prescribed drug in America The benzodiazepines remain extremely popular with more than a half dozen representatives on the list of the top 200 pharmaceuticals Antipsychotics In the mid 1950s more than half a million patients were institutionalized in mental hospitals with the development of antipsychotics the fi rst was Thorazine residence in these institutions is now at an irreducible minimum a small number of patients who cannot be released into the community Most outpatients take one or more of the anti schizophrenic agents which allows them to live in the community without major disruption The antipsychotics are not addictive they do not cause withdrawal symptoms and it s impossible to overdose on them But antipsychotics do cause side effects including diminished mental capacity involuntary movements of the mouth and tongue tremors a shuffl ing gait and repetitive rhythmic movements like rocking back and forth Antidepressents Depression is a serious mood disorder that psychiatrists believe
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