Betwixt The Sheets: The History of Sex, Scandal & Society - Psychiatric Drugs

Episode Date: May 3, 2022

*WARNING this episode includes adult themes and conversations about mental health and drug use.*In 2020, the UK government revealed that 17% of the adult population of Britain were prescribed medication for their mental health. But when were these drugs invented? How were they tested? And how have they become, in some cases, ‘mother’s little helper’?From antidepressants and anti-anxiety medications to stimulants and mood stabilisers - Dr David Healy takes us on a journey through the development and use of psychiatric - or psychotropic - medication, and how this development has in turn affected our diagnoses.David is a psychiatrist and psychopharmacologist, and is a professor of Psychiatry at McMaster University in Canada.Produced by Charlotte Long and Sophie Gee. Mixed by Aidan Lonergan.Betwixt the Sheets: The History of Sex, Scandal & Society. A podcast by History Hit.This episode includes music by Epidemic Sound and archive clips from Zoloft commercial 2001. Hosted on Acast. See acast.com/privacy for more information.

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Sign up to join me in locations around the world and explore the past. Just visit historyhit.com forward slash subscribe. Before we start, I should warn you that this episode contains mention of mental health issues and drug use, some of which can be upsetting. You just shouldn't have to feel this way anymore. Only your doctor can diagnose depression. Have you always made the point to kind of cover off? Then we feel. Up as down as pingers, poppers and more.

When we think of drugs, we often yo-yo. between thinking about painkillers and antihistamines, through to wondering what recreational drugs our favourite artists are taking to be inspired. But pharmaceuticals are also used in the treatment of mental illnesses, so drugs mean all types of things. How and when did this all start? Join me betwixt the sheets to find out. What do you look for a man?

Oh, money, of course. You're supposed to rise when an adult speaks to you. I make perfect copies of whatever my boss needs. by just turning it up and pushing fun. Yes, social courtesy does make a difference. Goodness, for a beautiful time. Goodness has nothing to do with it, there is. Oh, and welcome back to Bertwix the Sheets,

the history of sex scandal in society with me, Kate Lister. In 2020, 7.3 million people at 17% of the adult population of Britain were on medication for their mental health. And that was before COVID. Today I want to find out where these drugs came from and how they've become such a mainstay in the pharmaceutical world. I'm talking to psychiatrist and psychopharmacologist David Healy to get the inside track on psychotropic drugs.

Let's begin. Welcome and thank you for joining me between the sheets, Professor David Healy! Kate, it's good to be here. This is a really fascinating history, and it just goes on and on and on forever. But what I really want to talk to you about is what are called psychotropic drugs and their history.

Yeah. So could you possibly just explain, like, what is a psychotropic drug? Well, these are drugs that we figure help our nervous problems, our mental problems, by getting into the brain or the nervous system. Now, the idea that to be a psychotropic drug comes from the mid-1950s. Before that, obviously, people for millennia, like the Greeks, the Romans and the Indians and all sorts of other people, had thought, yes, we can hopefully help the nervous problems people have with drugs, but they figured these drugs were actually affecting

the body rather than the brain. It's only in the 1950s that we get the idea that the brain's involved. Now, the idea that we can fix our nervous problems by treating the body actually probably makes a lot of sense still. People don't think that way. Repeatedly again and again, And again, when I get face with people who are having problems on the antidepressant group of drugs, which blunt their emotions or change their memory and things like that, they always assume it's doing something in the brain to cause these problems. But in fact, it needn't be. A lot of the problems we have with what we think of as our mental functions can happen because of the action of these drugs on the rest of the body rather than in the brain. Oh, that's fascinating. So we think

of it as being in the brain, but it's actually... It's all connected and it could well be a body issue. In the body, yeah. Up till about the 1950s, everybody thought the brain was electrical. And the idea that you were going to use a drug to treat nervous problems in the brain didn't seem to make sense. It was only in the 1950s. And because probably of two or three different drugs that we got the idea that there might be

chemicals in the brain as well, that these drugs act on and that that might be how they have an influence and how we behave. And of course they do. But just to give you a simple feel for the issues, are the serotonin in us that the so-called selective serotonin reuptake inhibiting antidepressants, the SSRIs, like Prozac, for instance, the serotonin that they act on? Well, 95% of that is in the rest of our bodies. Only a little bit of it is in our brains. No, I did not know that. Oh, absolutely. It's in our gut and our bloodstream and our muscles and our bones. and all sorts of places, and only a tiny amount of it is axi in our brain. So if these drugs have an effect in our behavior, which they do,

it's not necessarily the case that it's going to be through their action in the brain. For instance, as regards treating the sexual problems that men have, you know, they're very fragile creatures, man, okay? And if they're thinking about trying to make love, for instance, then some men come too quickly. Now, one of the things you get with an SSRI drug is within 15 minutes of your first pill, if you're male and also if you're female, but these drugs can cause genital numbness. No way. And that fixes what appears to be a nervous problem, you know, the fact that the person's coming too quickly.

It's not an action on the brain that's causing this. So this is just trying to bring things home to people. But as of the 1950s, it seemed a good idea to start thinking more in terms of the drugs acting on the chemicals in the brain to treat nervous problems. And this is where the idea of a psychotropic drug was born. Wow. And the key drug probably in all this was a drug called chlorpromise. And this is the drug that gives rise to all of the antipsychoticists we have and all of the, antidepressants we have. And where it came from was the big deal back then in sort of the 1920s,

30s, 40s was to create antihistamins. And people were... For the allergies, antihistamins. Well, yes. You think of an antihistamine now as a trivial kind of pill. They use for hay fever and runny noses and things like this. But actual fact, the key area back then that people were looking at was trying to create antihistamins and trying to create them in a range of... different ways. And essentially all of the antipsychotic drugs we have and all of the antidepressant drugs we have are effectively antihistamins. Okay, so an antihistamine, but you could end up with numb genitals. Yes, absolutely, yeah. Wow. Okay. And if, for instance, you were trying to treat mental illnesses, if you're trying to treat a mood disorder, let's say you were overanxious, there are a number of

SSRI antihistamins that are available over the counter. They're called antihistamins. People don't realize that they're also SSRIs. And the big thing about them, and the good thing about them often is that if you go and get these drugs over the counter, they can make you less anxious. But if they don't suit you,

you decide pretty quickly that this isn't the right pill for me. But if you go to a doctor like me and get essentially the same kind of drug and they aren't really suiting you, they don't make you feel good or whatever, you get inhibited from halting them because this nice Dr. Healy has said, I should keep taking them.

They take a while to work. And people, because of that, often keep taking these drugs when they really shouldn't because they can be causing problems. And the same kind of way, you know, you think of, well, the drugs that treat serious mental illnesses

like chlophromazine, so the drugs that all came from it, that you surely can't get drugs like that over the counter. And in actual fact, you can. You know, there's a range of drugs we use for nausea and vomiting, which are essentially the same pills. And you could use, I mean, they have been used to treat major mental illness also. So we've got a mystique about a bunch of drugs that are fairly trivial,

which are able to get over the counter harmless, okay? and essentially the same drugs which get hyped up as being heavy-duty pills that really cure illnesses and things that. Well, really they don't. They can be helpful, but they're not an entirely different kind of beast to a bunch of drugs that many of us use day and day. I had no idea. I had absolutely no idea that antihistamines are the same sort of family as Prozac and selective serotonin re-uptake inhibitors. That's just wild. Let me tell you a little bit more about it.

Please do, yes. I'm still reeling from the numb genitals, to be honest, to go on. Yeah. Okay. Well, what you've got is this key drug. It's called chlorpromise. Yeah. And what the pharmaceutical industry had, and this is particularly the French industry, they were in the business of making antihistamins and they made, as you'll hear in a moment, some really interesting ones. But they'd made some antihistamins and everybody, when these new antihistamins were actually tried, try them out for mental illness. Because often they would help people get to sleep and things like that. They kind of calm people down by putting them actually to sleep. Okay? What one of the French companies thought would be a good idea is this recognized way

to make every drug that little bit stronger. And that was to chlorinate it. Now, when I say a little bit stronger, I mean a little bit more poisonous. I mean, if you're going to make a drug stronger, then chances are it's going to do more, which could actually be a problem. That's right. So they chlorinated an antihistamine called bromazine and made chloropromosine. And it was been used to create a condition called artificial hibernation for people who are going along for surgery. Okay, the idea was to shut the body down, to prevent it reacting to the kind of stress you get if we're, we're doing open heart surgery. Say we were going to open your chest or whatever. That would be

quite stressful. That's very stressful for the body, for the body, okay? Not the mind, the body. And the idea was to damp things down. So the body didn't try to overcompensate because that's where lots of the problems come. And the surgeon giving this new antihistamine found yes, it did chill things down. People didn't get over hot or whatever. But also he noted that when you gave him this drug, they kind of zoned out a little bit. They didn't pay as much heed to what was going on. They didn't seem to be bothered in quite the same way they'd been beforehand. And then one of his colleagues thought she'd try it and was driving a car and noted that when she took this, driving the car, she just didn't bother about the red traffic lights. She didn't notice they were there.

So this is what gave rise to the idea that this antihistamine might be particularly useful. It didn't actually pull people to sleep, but it seemed to zone them out. Right. And that's where the idea of an antipsychotic drug comes from. And in an effort to try and actually make more of them, one of the other companies, which is actually based over in Switzerland, accidentally made the first antidepressant. How did you accidentally make antidepressants? Well, you're in the business of trying to make another antipsychotics.

So you tweak the molecule a bit and you give it to a bunch of people. who seem to have psychosis, and it turns out not to be working all that well, but one of the doctors giving it notices, yeah, it's not working all that well for the people who get chlorpromosine, but actually there's a bunch of people who seem to be profoundly depressed, who don't react badly and actually after a week or two begin to recover, it seems. Okay? This is how these things happen. Actually, the best discoveries are things like that, where people just, on the pills are people who are looking at the people on the pills notice things happening that aren't part of the script.

See, that's how Viagra was discovered. Oh, totally. Absolutely. Is that right? Well, that's exactly what I was thinking about when I told you that, yes. Is it right that I can't remember what it was being trialled for, but they're... It was actually been tried for heart problems. Right.

Yeah. And it didn't seem to be any better than what was on the market for heart problems. prior to that. So the company thought they'd halt the clinical trial and some of the people said, look, could we hang on to the pills we have? And it was only when they were asked why that the company realized, gosh, this is interesting. I love that. The whole sample trial group just going, can have them back? No, no, you can't. And all their partners as well. So what about something like lithium? Where did lithium come from? Is that an antihistamine? Is that No, now that's an awfully good question. No, it's not. No, no, no, no. It's just a piece of rock, literally. The word means rock. Okay. And there's particular kinds of stones, and this was actually up in Sweden first. There were particular stones that it turned out that they contained lithium ions. And I think the person that isolated it from a stone first and gave it the name stone, because it came from stone, okay, found that actually some mineral waters,

which were the kind of mineral waters that people have been saying for ages are useful and spares. They're health-giving. They restore people that they contained lots of lithium in it. Lithium. And that led to an interesting little thing, which was there's a drink.

Now, I'm not sure if it's there still. I suspect it's gone. But there's a drink that used to be around the place when I was young called Seven Up. Seven Up, yes, I'm aware of Seven Up. Which began life as a lithium-containing drink. No, it did not. Absolutely.

Yes. So seven up had lithium. I was just trying to work out, like, how does somebody extract something from a rock? What do they think that they're doing at the time? It's such a strange route from, this is a rock, to we're now going to treat someone with mental health conditions, and now it's a bottle of pop. And lithium still used today, isn't it?

Well, absolutely, yes, yes. Now, the problem is it's so cheap and it can be got easily and things like that. It's very hard for the pharmaceutical industry to make money. out of it. It's probably the best treatment for a lot of people who've got serious bipolar disorder. But because the pharmaceutical industry can't make money out of it, you don't hear about that. You hear about a lot of other anticonvulsants instead, which for most people aren't as good and can be much more harmful. Now, lithium's not harmless. You do have to keep an eye to make sure that you're not on too much of it, you know, and you do have to keep an eye on people's kidneys

and thyroid and things and that. But it has been absolutely wonderful for loads of people who've had really severe mood kind of issues. It helps keep them on an even keel. But let me take you quickly back to the 1950s because the story gets really interesting. There's things that, well, maybe there's echoes of this going on now. But what people found when they had discovered chlorpromising and that it might be useful for treating people who've got mental problems was,

Two things. I'm going to go a little bit around the houses here. One is, when they gave it to people who were seriously delirious, you know, they had a high fever, they were out of their minds, they were totally confused, it really worked tremendously well. It really calmed those towns pretty instantly. Okay. When they gave it to people who had bipolar disorder who were very, very high, who were all over the place, overactive, over-talkative, grandiose, disinhibited, and things that, that, again, it worked. wonderfully well and terribly quickly. What you find in the mid-1950s, the people who had actually discovered it first and get written out of the script when they began using it to treat major kind of nervous illnesses were the nursing staff on the ward. As I told you, it was used, first of all, for what was called artificial hibernation. And if you're going along for surgery, we're going to pack you in ice and we want to chlorpromising to stop the body trying to heat. itself back up again. Okay.

And when they gave it for nervous problems first, the patients on the mental hospital ward were packed in ice and then given for prosy. And it was the nursing staff who said, look, you know, we've been around here for a while and we can tell you you don't need the ice. Just give the drug. Okay. But one of the other things that came out of this was that when you gave LSD, which had just actually been discovered a few years before that,

people were able to see that, well, okay, if you took LSD and you're on a trip and you took chlorpromosine, it brought the trip to an end instantly. Oh, I mean, that's a public service announcement right there, David. It is, but the interesting thing about it, wait for this. One of the hunches they had was, well, now that we have a drug that causes mental illness, LSD, okay, which makes you crazy.

I can see that, yeah, okay. Supposedly, okay. And we have a drug that cures it. We'll be able to work out exactly what's going on in the brain pretty quickly. That was 70 years ago. And we have not worked it out since. But in the interim... It's just sheer laziness.

In the interim, I mean, there was a big fuss in the early 50s. People were awfully aware that LSD could cause people to sort of be out of it, sort of thinking crazy things, doing odd and strange and crazy things. And almost a bit like a plot from Killing Eve, there was a lot of worry that the Russians were going to poison the drinks of the Americans with LSD and the Americans were going to poison the drinks of the Russians and things that. And at one point in France, there was an episode where a whole town went mad. With LSD?

Well, this is the early 1950s. And a lot of people have thought, ever since, and it's hard to get to the truth of this, that what had happened was LSD had been put in the drinking water to see what would happen if we were trying to use it as a weapon of war. So the hunch is that somebody just, oops a daisy, I just dropped that in and has been recording the results. That's the hunch. Yeah. Scaliwags. But there were two other things. Like, first of all, there was the idea that Chloropromazine could bring an LSD trip to an end. There was the first.

a drug, there was an Indian drug that goes back hundreds of years, a drug called reserpine. And that was a drug that was used again to treat physical problems. It helped you fall asleep. It lowered blood pressure and it treated nervous problems. It was awfully useful. Now, in the early 1950s, when the idea about chlorpromising and LSD came out that we will be able to work out what happened in the brain. When people gave reserpine and looked at what happened, they're able to spot that it lowered serotonin levels, which is where the idea about lowering serotonin, this may be what happens in people who are depressed, actually comes about. Now, it isn't what happens in people who are depressed. There's nothing wrong with the serotonin system in people who are

depressed, but that's what the idea comes from, and that's the mid-1950s. Wow. Stay tuned and come back after this short break, because I will be talking to David about Mother's Little Helper, and some of the many times when these drugs have gone horribly wrong. Now, there's one more antihistamine from the mid-1950s that I probably should mention to you. Please do. Which was, while the French industry were trying to create antihistamins, and the one that really worked for them was Cloughpromising. They also, and this was just before World War II,

they created a different kind of antihistamine, which they didn't market. I mean, it's just they created loads of them, and there's no great reason to think that they didn't actually market it because they knew what was going to happen next. It's probably more a case if it just didn't look hugely promising. I mean, there were two or three other drugs they had that looked really interesting. And after World War II was over, I mean, you know, World War II got in the way of people trying to bring new drugs in the market and things like that. But after World War II was over, German company asked the French company, look, you know,

that antihistamine you have, could we have it? And we'll actually put on the market. And they did. And that antihistamine was called calidomide. I have heard of that. Okay. Everyone has. Sure. And it was actually brought on the market first as a drug to help you sleep, which is what the antihistamins did. Oh, I didn't know that. And as a drug to calm you down, which is what the antihistamins do. And as it turns out now, these drugs can also be useful to treat cancers as Prozac and other S-S-R-Is can be and useful to treat COVID as Prozac and other... Philidamide is?

Well, yes, but no one's going to take telitomide. No, oh God, now for a second I'd almost forgotten what it did. Sure, yes. Of course. Oh, right, okay, yeah, I'm back on track now. But that's wild. Isn't it? The whole thing.

But it could theoretically treat cancer. I mean, it is actually on the market in the United States to treat cancer. Wow. So, you know. And have there been other, I mean, we know the history of philidomide, just for anyone who's listening who isn't aware of it, it causes horrendous birth defects if it's taken by pregnant women. But have there been any other drugs that have been used, marketed,

everyone used them. And then there was a kind of, oh, shit, that really, that's not good at all. And it's been discontinued. Well, the one that's currently in the news is an actually. anticonvulsant called sodium phalproate. Sodium phalprote. Okay. Now that's used to treat people who are having fits, but it's also used. It's one of the most commonly used treatments for people who've got bipolar disorder.

Right. Now, the interesting thing there is this begins life in World War II in Germany, okay, where we were not being awfully nice to the Germans during World War II. We were kind of treating them the way we were treating maybe the Russians today. and the Germans ran short of butter. Right. And they realized they could make artificial butter from a compound called Valproic acid.

Who amongst us has not? How do you get to that? One of the things that they also jumped to with that was, well, actually, this is an awfully good medium to dissolve other drugs in. Ah, okay. Drugs that they were trying to check out, but you needed to get them to actually dissolve

in order for animals, are humans to actually be able to take them. So they began using valproic acid. And after the war, a French pharmacologist who was doing just the same thing, began to realize this valproic acid looks like it does things in its own right. Maybe if I just give it on its own without the other drugs in it. And he found that it was a useful anticonvulsant and persuaded the local hospital to begin using it for the people in the hospital who had epilepsy.

Yeah. But at that time, people who had epilepsy were quite likely to end up in mental hospitals, because this is clearly a brain illness. So the hospital who has been used in was a mental hospital who noted, and maybe this was because of the job they did that didn't just prevent convulsions. It seemed to make people less irritable. It seemed to calm them down a bit. So they began using it for people who had bipolar disorder.

And this is really what led to the change in. name of this illness. It used to be called axiomanic depressive illness. I remember that. And because of the advertising that went with sodium valproet been used for this illness, the name changed to bipolar disorder. Okay. Now, the interesting feature about all this is we've known for a long time that this drug causes breast defects also. And just in the last week here in the UK, there's been huge news about the fact that MHRA and other people have known about this for a long time, and pregnant women are still taking it. Oh, my God.

And it's an interesting drug because it doesn't just cause birth defects in the children who are born to the women who are on this drug during pregnancy. It seems to have transgenerational effects. That is, the children who have been born to mothers who are on it, can themselves have children who have defects on it, even though they're. mother never had the drug, at least. Oh my God. Not during the course of, you know, the pregnancy are for years beforehand. She herself had it in the womb, you know. So why is this still being prescribed? I mean, that sounds deranged to me. On what grounds is it still being prescribed?

Well, in terms of treating convulsions, it is actually among the best drugs we have. In terms of treating bipolar disorder, it's not as good as lithium, but it's much better than a lot of the other anti-convulsant drugs that are used for this purpose also, but it should definitely not be given to pregnant women. Wow, that's just wild. Speaking of mothers, here's something that I want to ask you about, I'm pretty sure that my grandma had a Valium addiction in the 50s, along with millions of other women. Could you talk a little bit about what the Rolling Stones called Mother's Little Helper? Of course, okay. Yeah. Now the song, the Rolling Stone's song, I think was 1965. It's not absolutely clear just what drug they're referring to.

But the idea of a tranquilizer appears in the mid-1950s. And there was a drug in the United States called Mepro Bamate. And the key thing here was that up till then, we've been using drugs like the barbiturates. People like film stars, movie stars, Hollywood people and things that. when they needed to get to sleep and calm themselves down, they were using barbiturates. Up as and down is, up and down is, right. Yeah, which were lethal in overdose. Okay, so people were thinking, well, can we get a safer version of this?

And this new drug was a safer version. And the interesting thing about it was it didn't particularly put people out cold the way the barbetturts. You could take this drug and be calmed down without falling asleep. Okay. And the guy who made the drug said, look, the interesting thing here is it may not actually be the brain. You know, we may not have to get into the brain to calm people down. This drug is a muscle relaxant. And maybe if we focus on trying to relax tense muscles, people will feel calm.

It's a bit like if your heart rate goes up awfully high, we feel anxious. I mean, if our heart beats awfully fast, we feel anxious. And one of the ways to treat people who are anxious is to give them of what's called a beta blocking drug, which is one that slows your heart rate and fools you into thinking, well, maybe I'm not quite as anxious as I thought, okay? In a sense, the brain is only there to try and work out what's going on in the body. Why is the heart rate so fast? So if you can slow the heart rate down, you can maybe fool the brain. And it was the same kind of idea that led to the minor tranquilizers as they're called. Shortly after the Meprobaamate drug actually came

the market, which was the mid-1950s, and there was a huge craze about it. Everybody began taking it. And it looked like it was going to be here for all time. All of a sudden, it was replaced by the Benson-Azeman group of drugs, which did the same kind of thing, relaxed muscles, but did so even better. They were less likely to be drugs that caused you to fall asleep. Okay. And the first of these drugs was called Librium. Librium. That was pre-valium. Librium was came on the market by 1959, 1960, Valium came a few years later. It was 1963. So whether the Rolling Stones were actually referring to Meprobamate, our Librium, our Valium is a bit less clear because the big-selling drug in the early 1960s was Librium. Valium by the late 1960s, but this is after Mother's Little

Helper becomes the best-selling drug in the world. Wow. It's just seen as a wonder drug, which is terribly useful for people who are anxious, calms you down, lets you function and things of that. And we had the kind of scenario we have now today, kids going to college, were a bit nervous about going to college and things of that. Well, have a valium. Patients who are hypertensive, your blood pressure is up. Well, sure, it's just your blood pressure, but it kind of suggests you're anxious as well. Why not have an anti-hypertensive and a valium? Absolutely. Got a driving test. Have a valium. If you're depressed, you're going to be anxious too, so have an antidepressant. plus a valium. And just to bring the point home, during the 1960s, very few people were depressed.

That's an interesting claim. Okay, God, explain that one to me. The pharmaceutical industry didn't see any money in it. There was nothing in it for them to try and persuade you, you were depressed. They had the perfect treatment for the nervous problems you and I had. We were obviously anxious. We were having nervous breakdowns. We were tense. We were anxious. And did they, have the perfect treatment first? Yes, absolutely. Wow. Okay. And it's only during the 1980s when it becomes clear that, well, yes, it is a wonderful treatment, but some people get badly hooked to it and really can't get off. It took that long. It took like 20 years for people to go, hang on me. No, no, great question. Right from the very start, within a year or two of

the benzodiazepine drugs being out in the market, people recognize that you could get hooked to them. But it takes 20 years to get from the first recognition to the idea that these incredibly profitable drugs really did have a problem. Not for all people. They can be wonderful for loads of people if you don't give them too high a dose, etc., etc. I mean, if you don't put them in their breakfast cereal and their lunch drink and their evening meal, you know. Please don't do that. Anyone listening?

So in the 1980s, a big fuss came about because people were being hooked to the benzodiazepins. And the professional groups all said, no, no, no, no. this isn't the case. This is just the nervous problems people had to begin with. But no, this is the case. These drugs did cause this problem. And the people who really made sure that we knew the drugs caused a problem were the pharmaceutical companies, who wanted to replace these wonderful and marvelous drugs, which are now awfully cheap and they couldn't make money from them, with a new group of drugs acting on the serotonin system, which were going to cost a lot more. But they realized that we can't sell either doctors, our patients the idea that we have a new anxiolitic drug that you're not going

to get hooked to. Okay. Doctors will say, we've heard that before, we should not going to believe it. So they decided we're going to convert everybody who was previously nervous and anxious into being depressed. And they're going to be told that, you know, underneath every case of anxiety is a mood disorder. And if you want to treat the anxiety, why don't you clear up or cure the real problem? That's interesting.

Which is the mood disorder. So as of the late 1980s, early 1990s, we get the SSRIs. And the Gartisan features front page articles about has the UK become a low serotonin people? Okay. Literally. Literally. That's the kind of thing that was being said. And artists were using SSRIs because they're going to be making the,

them more creative and better than well and things like. And books like listening to Prozac came out claiming that these drugs make you better than well. Wow. They even make claims these drugs can convert you from being homosexual to heterosexual. No, they did not. Oh, absolutely, totally. Oh, my goodness. So this looked like win, win, win.

You're going to be more efficient and less gay and happier and all sorts of things. sexually normal and more creative, what is not to like about this? And, you know, the SSRIs took off. But in actual fact, while they suit some people, they're really not terribly good as antidepressants. I'm just going to say, yeah, is it like we're not saying that they don't work? No, we're not. But if you're looking, I mean, the issue is for the industry, the place where they make money is not the people who are severely ill who end up going into hospital. who are rare. The place where they make money is the nervous problems we all have, from kids these days to old people. That's where the money is simply because there's so many more people

who are out there living at home, working in jobs and things that, figuring they could need an extra little something to help them. Wow. That's what the money is. Okay. So if you've got a person who's severely depressed, who's going into hospital and things like that, SSRIs just don't work for them. literally do not work. It's the older drugs were actually discovered back during the 1950s that are still the best group of drugs to give people who are very severely ill. The SSRIs replace the benzodiazepines in essence. It's so bleak, isn't it? When you understand it as a business, which it's kind of very naked business in America. And I think in the UK, we have this idea that it's the NHS and it's lovely and it's free, but there is still money to be made.

Oh, I think the pharmaceutical industry figure that they can play the NHS much better than any other system around the place. Dark, isn't it? I could speak to you. You've blown my tiny brain repeatedly. But I'm going to have to try and draw it to close, mostly so I can sit down in a darken room for a little bit and digest some of this. But what's the future of pharmaceutical drugs? Because I've been reading things like LSD is being used for microdosing and things like that. I mean, what's the future for psychotropic drugs, do you think?

Yeah, well, I think one of the things is, in essence, if you look at the SSRIs, just to come back to the point that I made first, these are not new drugs. They're really old drugs that go back to the antihistamins we had during the 1950s. And in fact, despite all the hype that were making major breakthroughs the whole time, there's been very little real progress in terms of trying to help us with the nervous problems we have, either trying to understand what causes them are how to actually put them right. Now, as you've hinted, drugs like LSD come out in the late 40s and early 50s, and there was a lot of interest then in using them to treat nervous problems, not just to cause people to have nervous problems, but to actually

treat them, and very good evidence that they could be awfully helpful for a range of different problems. And that's almost certainly the case now still. Magic Mushrooms, ketamine, LSD, and drugs like this do have a real place. We still need to work out just what the real place is. And the pharmaceutical industry need to work out of it, how they're going to make money out of it, or else these things aren't going to happen. But it's unquestionably the case that these drugs have a role. But again, they're still, you know, the 1940s, 1950s, nothing terribly new has actually happened. And, you know, in terms of asking me where things are going to go from here,

well, it's kind of hard to know. Partly, the fact that we're getting interested in LSD and things like that again suggests to an extent we're scraping the barrel. Not because these drugs aren't useful, but it's just because they're so complex and tricky. They wouldn't have come back into use if the industry had anything else they could make money from. So it's not so much that this is brand new pioneering. This is more like we're circling back to try things that people were trying the safety.

It was awfully clear that LSD and drugs of that could be useful. Not for all problems. I mean, when these things got used first, I'm sure they were used for all sorts of conditions that they shouldn't have been used for. But in the midst of all that, it was clear that there were a group of people who are hooked on alcohol and things like that, who were hugely helped. by them. And it's the same now today. Wow. So there's been no real advancement. We're kind of just experimenting with the same

drugs that have been turning up for a while. But would you say that perhaps going forward, we need more focus on the body as well? Because I think there's still this idea that if you just take a pill, your head will be okay. Yeah, it is curious. The wider culture has brought into the idea of it's all happening in our brain. In your head, yeah. I can understand. that, well, I can understand that in terms of what the world it's all about is really happening in the female brain, but the male brain is a very simple brain, and it isn't actually responsible for a huge load of things, you know. So, yeah, no, I think there must be greater focus on the overall body. I mean, the brain has a role in this, but it's not the

master computer that we tend to think of it as. And we need to think a little bit more about things we can do to the body that might be helpful for our overall kind of nervous problems. But the other key thing in the midst of all this, I think, is that we've almost brought into the idea that we're all mentally ill to some extent. And we're not. You know, there's a lot of problems in the world. There are things that are really scary like COVID. There's the war in Ukraine. There's a whole bunch of things that are really scary that need to be sorted out that are not going to be sorted out by a pill.

being healthy, being mentally healthy, is almost taken the place of what used to be being holy or being political, you know. And to some extent, one of the things that needs to happen is not better and better pills somehow to shrink health back. So it's only part of our lives. It's not taking over all of our lives. The world is crazy and perhaps you're not as mad as you think you are. You're reacting to it quite normally. That's a very good way to think about it. Yep.

Oh, David, thank you so much for joining me. You've been an absolute pleasure and a treat, and I'm going to go and buy a bottle of seven-up. Take care. Thank you so much for joining us for this chat about psychotropic drugs, and thank you so much to our guest, David Healy. If you like what you've heard, please don't forget to like, review and subscribe wherever you get your podcasts.

In the next few weeks, we've got episodes on cadavers, royal sex, and vasectomies. This episode was produced by Charlotte Long and Sophie G, and includes music by Epidavis. sound. Join me again betwixt the sheet, the history of sex, scandal in society, a podcast by HistoryHit.