Book Review: Amphetamine's Missing History

David Healy

Three recent histories—Andrea Tone’s Age of Anxiety, Daniel Herzberg’s Happiness Pills and Ned Shorter’s Before Prozac—ccover the emergence in the 1950s of a “Madness for Miltown,” a popular brand name for meprobamate, a best-selling tranquilizer. In the 1960s the craze was for benzodiazepines—mother’s supposed little helpers. All three authors note that the new drugs were better and safer than the barbiturates they replaced; Shorter goes so far as to say that meprobamate and the benzodiazepines were among the most effective medications ever created. But astonishingly these books only briefly cover the amphetamines—if at all. Whether in pure form, as Dexedrine or Benzedrine, or in combination with barbiturates, as in Dexamyl, amphetamines long antedated the tranquilizers and heavily outsold them as late as the 1960s.. 

It is difficult to account for this blind spot. Is it lack of political drama? The benzodiazepines ran into trouble in the Englishspeaking world, with media accounts of the horrors of unwitting addiction, betrayal by the medical profession, and a series of congressional hearings. This didn’t happen with the amphetamines. They did eventually fall out of favor and became controlled substances, but one has the impression that this was almost as a side effect of actions involving the benzodiazepines and psychedelic drugs: amphetamines seem almost to have been a convenient scapegoat. More recently amphetamines have made a comeback, largely as a treatment for the increasing numbers of children and adults who are being given diagnoses of attention-deficit hyperactivity disorder (ADHD). In both its diagnosis and treatment, ADHD offers plenty of drama and debate, especially in its lopsided demographic of male children and adult women: it is the only disorder in medicine that shows such an astonishing age-related gender switch.

Chemically, the comeback of the amphetamines is surprising in that there are no new drugs here. The best-selling amphetamines today are extended-release forms or isomers of older drugs. We as a society
also seem to have an intriguing capacity to view the clinical uses of amphetamines as benign enough for children, while at the same time viewing closely related compounds like crystal meth and cocaine as a scourge upon our future. In contrast, the benzodiazepines have no close relatives that can be regarded as dangerous, yet Valium now casts a darker shadow than Dexedrine or Ritalin or Prozac.