Life
A History Of Modern Antidepressants, From Opium To SSRIs
Depression has been around in the human consciousness for a long time — it's just had some different names (and some very strange treatments). In ancient Greece, the theory of "humours" dictated that people with depression (or "melancholia") simply had too much of one particularly substance, black bile, in their bodies, and that it was as simple as correcting that imbalance through your diet. (Greek physician Hippocrates advised avoiding meats "hardened by salt and smoke".) It took a long time for melancholia to evolve from an imbalance into a mood disorder with a more official name (depression), and even longer for us to develop drugs as remedies, rather than, say, imposing "rest cures" (being confined to your room for six weeks in isolation while being grossly overfed).
If you take an antidepressant nowadays, chances are it's Prozac, Citalopram, or something of that ilk — but behind these easy, modern pills are nearly two centuries of exploration, experiment, and peculiarity. (Opium injection, anybody?) It's been a wild ride. Join me in the history of antidepressants — and clutch at your prescription with gratitude.
1800s: St John's Wort Nerve Tonic
Depressives will probably have heard of St John’s Wort, a plant which has antidepressant properties when ingested by humans — but it was also one of the first medicines meant to relieve the symptoms of depression. St John’s Wort nerve tonics were popular in the 1800s, and the plant was classified as a “nervine” that could treat nervous disorders — but little was understood about how the nervous system or the brain actually worked.
Note: if you’re on antidepressants now, don’t go get yourself some St John’s Wort too — it interferes with most of the medications on the market.
Image: Wikimedia Commons
Early 1900s: Opium Is Used Widely
Opium and its variants have a pretty long history of use in the treatment of depression, though it’s more famous for pain relief. From around 1850, opium was specifically approved by doctors to treat “melancholia,” and in the early 1900s a German doctor named Emil Kraepelin declared it the best solution for “agitated” depressives.
These days we use opioids for pain relief; most strong narcotics have a bit of opium in them in some form or other.
Image: Wellcome Collection
1935: Amphetamines Are Marketed As Antidepressants
Amphetamines came into the antidepressant world with a bang in the 1930s: they were hugely popular as “pep-up” drugs, particularly ones like Benzedrine, and were prescribed for the U.S. Army and housewives alike.
The idea was that more energy (which is definitely what amphetamines gave you) stimulated the nervous system, boosting depressives out of bed and making them more active. Unfortunately, this didn’t address the root of the problem at all.
Image: American Journal Of Public Health
1955: Tricyclic Antidepressants Discovered By Schizophrenia Researchers
The first tricyclic antidepressants — so-called because their chemical structure has three “rings” — were discovered by Roland Kuhn and his fellow doctors while they were trying to find a treatment for schizophrenia in the 1950s. They were trialling a drug at the Munsterlingen asylum in Switzerland when they discovered that it actually boosted the moods of patients.
Turther studies confirmed the results, and the first tricyclic antidepressant, Tofranil, went onto the market the next year, followed by floods of imitators. The age of custom-made antidepressants was born.
Image: Switzerland Design Collective
1958: The First MAOI Found In Tuberculosis Trials
MAOIs, or chemicals that inhibit monoamine oxidase, are still in use as heavy-duty antidepressants, and, like tricyclic ones, they were discovered by chance — this time in tuberculosis trials. Patients who took the new experimental drug became “inappropriately happy,” and the stunned researchers turned around their study and managed to release the drug onto the market as an antidepressant in 1958.
Image: Wikimedia Commons
1966: The First Of The Atypical Antidepressants Launches
Wellbutrin was the first of the antidepressants on the market not to fit the “typical” areas (tricyclical, MAOI, and now SSRIs or SNRIs) — so it’s part of a group called the atypical antidepressants. Its dirty little secret is that it was inspired by the chemical structure of amphetamines. History keeps repeating itself.
It got a bad reputation after it was associated with seizures and taken off the market, but it came back in 1989 after it was discovered that halving the dose solved the problem.
Image: CVS
1987: Prozac Is Invented
Prozac, or fluoxetine, is the most-prescribed antidepressant in history, and was the first of the selective serotonin reuptake inhibitors, or SSRIs, that characterize most antidepressants today. But, like the two other major antidepressant drugs before it, it wasn’t originally tested as a mood-altering drug at all: it was meant to help blood pressure.
Fortunately Eli Lilly, the company behind it, tested it on depressives when the first tests failed, and found a drug that has since made it billions.
Image: Wikimedia Commons
1993: The First SNRI Is Invented
A group of variants on the SSRI drug, SNRIs — a serotonin-norepinephrine reuptake inhibitors — were first invented in 1993. They were, and still are, marketed as safer, more targeted antidepressants than the heavier-duty tricyclics and MAOIS, and as having less side affects than SSRIs.
By this time, it was pretty clear that antidepressants were big business — so the drug company Wyeth, who discovered it, weren’t looking for anything else at the time, for a change.
Image: Wikimedia Commons
2013: Ketamine Becomes The New Antidepressant Hope
In 2013, ketamine — otherwise known as “the horse tranquilizer,” or as a party drug — garnered significant attention from antidepressant scientists when it was discovered that it could actually be a pretty effective depression medicine for serious cases. And we’re still trying to understand why.
At the moment, though, the fact that ketamine’s affects don’t seem to last (and the fact that it’s a party drug) seem to be standing in the way of its approval for antidepressant use. So don’t go running to a street dealer just yet.
