Book Review: Amphetamine's Missing History

David Healy

For these reasons and many more, I have been waiting for a book like On Speed for years. It is extraordinary that there has been no good history of a group of drugs that has been influential for both clinical practice and the wider culture for over 75 years. The antidepressants and antipsychotics, in contrast, had barely begun to register on the radar of public consciousness when books detailing their origins began to appear.

But the wait for this book has been worth it, not just because it is well-written but also because the story will be so unexpected for many people. Nicholas Rasmussen’s discovery narrative for Benzedrine outlines vast differences in the way drugs were discovered in the past and present. But those unfamiliar with any aspect of this history will be equally surprised to find themselves, at least initially, in the midst of a story about efforts to find a treatment for asthma and other respiratory problems.

Soon, however, the drug’s manufacturer began looking for broader applications (and therefore larger markets). In the 1940s and 1950s we see the pharmaceutical firm of Smith, Kline, and French promoting the views of Tufts University psychiatrist Abraham Myerson on the response of people with anhedonia (the inability to experience pleasure) to amphetamines. Similarly Smith, Kline, and French’s marketing campaign depended heavily on recruiting experts to persuade general practitioners that a large number of their patients might have psychosomatic problems that would respond to amphetamines. Rasmussen makes a good case that this was an early example of disease mongering. But he also notes that the drugs were openly advertised as antidepressants, creating another surprise: why is it that no history of antidepressants includes any reference to the amphetamines?

All of this should sound very topical to modern readers, as will a host of other revelations about links between industry and academia. As early as the 1950s Smith, Kline, and French appears to have been ghostwriting articles for doctors and drawing up research contracts with academics that enabled them to block the publication of inconvenient research findings. In recent months the media have been full of stories on the conflicts of interest that link academic medicine to industry. Many are beginning to wonder whether medicine is in a state of terminal decline. Since 1990, however, these interests have been declared, at least to some extent. Consider, instead, the case of Soma Weiss, a professor of medicine at Harvard University and chair of the American Medical Association’s Council on Pharmacy Approval. Rasmussen details how Weiss, without acknowledging the five-year grant he had received from Smith, Kline, and French for his clinic in Boston, endorsed Benzedrine as one of the most promising drugs ever developed in a 1939 review article on pharmacology. As Rasmussen makes clear, there has never been a golden age when medicine was free of the pharmaceutical industry. The question instead is whether something about the relationship has changed or whether we are simply witnessing an almost predictable periodic upsurge of medical Puritanism.

This book is much more than a discussion about the discovery of a treatment for asthma.

David Healy is a psychiatrist at the University of Cardiff and the author of Let Them Eat Prozac: The Unhealthy Relationship between the Pharmaceutical Industry and Depression (New York University Press, 2004).