Friday, February 22, 2013
My apologies, dear readers, I didn't forget this blog, there's just been a lot of stuff going on in Turkeyland. Moving house, recieving my fellowship, sitting exams and a wedding in six weeks.
So when I stumbled across some information on barbiturates I decided it was an appropriate subject for a post because I feel like I really need some....
Leaders have been experimenting with pharmaceuticals to improve the condition of their army troops for as long as armies have existed. We've already discussed the German's and their use of amphetamines during WWII. The Allies, too, tried distributing medications to their troops to try and make them perform better.
The best example of this is barbituates and the South Pacific theatre.
Barbiturates were first synthesised in 1864 by a German chemist. At low doses they have anti-anxiety,sedative and anti convulsant properties. First introduced clinically in 1904 by the German scientists Emil Fischer and Joseph Von Mering, working for the pharmeceutical company Bayer. They were particularly helpful in psychiatry as the first helpful medication for many disorders to come onto the market. However they were also eventually used to treat conditions as diverse as asthma and migraine (indications that seem shocking given what we know today).
However it wasn't until the 1930s and 1940s that barbiturates attained the peak of their popularity and widespread use. This was, of course, at the same time as WWII. Barbiturate use continued to climb, with some 70 tonnes of the drugs sold in the USA in 1936.
Worried about US troops being deployed the South Pacific, soldiers were issued with barbiturates. The idea was to lower blood pressures and respiratory rates to help soldiers better cope with the extreme heat and humidity.
(Image from Wikipedia, in the public domain)
Unfortunately after decades of escalating use the problems of barbiturates finally became clearer in the 1950s and 60s, first being identified in the literature in the 1950s. Many soldiers from the South Pacific returned with dangerous addictions to the drug requiring months of painful rehabilitation. By 1965 135,000 barbiturate addicts were recognised in England and 250,000 in the US.
The problem of barbiturates lie in their very small 'therepeutic window' meaning the dose at which the drug works but does not do harm. This meant that alongside dependence, overdose was common. Because of this barbiturates were also often used in suicide attempts.
Interestingly both Fischer and Von Mering are believed to have died from barbiturate overuse. Another famous case is that of Marilyn Monroe.
Countries all over the world began to tighten laws surrounding use of barbiturates, including making them prescription only drugs. This did little, however, as it should be noted that over 20 million scripts for barbiturates were issued in the United Kingdom in 1968.
What solved the problem was the introduction of better psychiatric drugs in the 1950s and 60s. The anti-psychotic chlorpromazine came onto the market in 1952 and the first of many benzodiazepines in 1960.
These days barbiturates are still used but in much smaller therepeutic indications. They have their place in the treatment of seizures, particularly in children, and are still occasionally used in anesthesia (although this is now rare). As a result addiction and overdose are rare indeed.
Of course, benzodiazepines have left us with another legacy of problems that we are still addressing today. But that's another story.