Psychiatry: What Tranquilizers Have Done

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Little more than ten years has passed since two psychiatrists first gave North American patients the new drugs that were soon to be widely known as tranquilizers. In so doing, they started the most dramatic and hopeful revolution in the long, dolorous history of mental illness. They are still at it. Berlin-born Dr. Heinz Edgar Lehmann, who introduced chlorpromazine at Verdun Protestant Hospital outside Montreal, is barnstorming at meetings called to find ways of developing still more and better drugs. New York's Dr. Nathan S. Kline, who introduced reserpine at Rockland State Hospital, is in Iran, fomenting a psychiatric revolution there. Just before he left the U.S., Dr. Kline told the New York Academy of Medicine what has been wrought in these ten years. It is impressive indeed.

Savings in Billions. Most notable, of course, has been the reversal of a once seemingly inevitable annual increase in the number of mental patients. If their numbers had continued to mount since 1956—when use of the drugs became widespread and fairly systematic—at the same rate as in the pre-drug years, there would now be 82,000 more patients confined in mental hospitals. "Instead," said Dr. Kline, "there has been an actual decrease of 54,000 patients, giving a difference of 136,000 persons." The care of these might-have-been patients over eight years would have cost more than $1 billion, Dr. Kline estimates; building hospitals to house the newcomers would have cost $2 billion more. Alongside such figures, the cost of the drugs and of drug research is "very modest indeed."

Anybody admitted to a mental hospital today has twice as good a chance of getting out as he would have had before the drugs. Therefore, said Dr. Kline: "Public-mental-hospital patients now come with an expectation of improvement, and they come earlier—when treatment is more apt to be successful."

Accepted as Illness. The drug revolution, said Dr. Kline, has opened up broad new avenues for the treatment of many patients formerly considered untreatable. Most important, perhaps, "it has begun to change centuries-old public attitudes toward mental disease."

Dr. Kline pointed out that today there is much "greater acceptance of patients back into the community, since psychiatric disorders are now much more-looked upon as illnesses, and as illnesses that can be treated. The fact that a condition is treated with medication somehow guarantees, in the public mind, that it is a genuine illness." One measure of this change is that one-third (by his estimate) of all packages passing across druggists' prescription counters today are for drugs that influence the mind.