Tranquilizer

A tranquilizer is a drug that acts on the central nervous system and is used to calm, decrease anxiety, or help a person to sleep. Often called depressants because they suppress the central nervous system and slow the body down, they are used to treat mental illness as well as common anxiety and sleeplessness. Available only by prescription, they can cause dependence and certain ones can easily be abused.

Major and minor tranquilizers

There are two types or classes of tranquilizers: major tranquilizers and minor tranquilizers. The former are antipsychotic drugs and the latter are considered antianxiety drugs. Antipsychotic drugs are used to treat patients with a severe mental illness, like schizophrenia (pronounced skit-zo-FREH-nee-uh). Antianxiety drugs are given to patients with emotional problems, like anxiety. Both types of tranquilizers were first introduced in the 1950s. At the time, they revolutionized psychiatry for they seemed to offer physicians a way to manage psychoses (pronounced sy-KOH-sees), which are severe forms of mental illness, and to make their patients emotionally calm and quiet. They also seemed to offer an alternative to people simply trying to cope or put up with the everyday anxieties, tension, and sleeplessness that many experience in their normal lives.

Major tranquilizers for psychoses

The major tranquilizers were first developed in the very early 1950s when scientists discovered that the organic compound called phenothiazine (pronounced fee-no-THY-uh-zeen) had a strong sedative effect, meaning it calmed or relaxed the person taking it. In 1952, a phenothiazine derivative called chlorpromazine (pronounced klor-PRO-muhzeen) was seen to make highly agitated patients quiet and calm without making them unconscious. However, it also made them much less aware mentally, as they seemed to have little or no interest in anything going on around them. These calming effects led doctors to begin giving this new drug (whose trade name was Thorazine) to severely disturbed, psychotic patients, since for the first time, science had found a drug that specifically targeted the central nervous system.

Words to Know

Anxiety: A feeling of uneasiness and distress about something in the future.

Insomnia: Inability to go to sleep or stay asleep.

Psychosis: A major psychiatric disorder characterized by the inability to tell what is real from what is not real.

Schizophrenia: A serious mental illness characterized by isolation from others and thought and emotional disturbances.

About the same time, another compound called reserpine became useful as a major tranquilizer. It was found to reduce the delusions and hallucinations of schizophrenics. However, it eventually was replaced by another class of drugs since it had several physical side effects. Although antipsychotic drugs or major tranquilizers have side effects—such as increased heart rate, dry mouth, blurred vision, and constipation—they are not addictive and patients seldom build up a tolerance for them. Since they do not give the user any of the good feelings that stimulants do (instead they cause drowsiness), they do not lend themselves to recreational use. They will not make a person feel "high."

Minor tranquilizers for anxiety

Minor tranquilizers are quite different, however, and although these antianxiety drugs are called "minor," there is in fact nothing minor or mild about these drugs. Nor is there anything minor about their effects or their potential for abuse. This class of drugs is the most common type of drug today. More prescriptions are written for these compounds than for any other type of drugs. Minor tranquilizers include the well-known brand names of Valium, Librium, Xanax, and Ativan. Unlike major tranquilizers, which are used by doctors to try and manage severe psychiatric illnesses, minor tranquilizers are given fairly liberally by doctors to patients who complain about anxiety, depression, and sleep disorders. Minor tranquilizers work by reducing tension without heavily sedating the patient. Although they relax tense muscles, they produce less sleepiness during the day than major tranquilizers, although at night they do help with sleep.

Though they should be taken in prescribed doses for short periods of time, many people take these minor tranquilizers regularly, and they can cause dependence and tolerance. This means that the patient may experience unpleasant withdrawal symptoms if they suddenly stop taking them, and that they eventually need to take larger doses to maintain a feeling of well-being. Minor tranquilizers are the most widely abused drug in the United States and are regularly involved in suicide attempts and accidental overdoses. Called "downers" on the street, they can give a feeling of calm and relaxation (some say a "floating" sensation) that can, however, turn into more serious and unpleasant side effects. Over-use of downers can make people hostile and aggressive, and leave them with blurred vision, memory loss, disorganized thinking, headaches, and depression.

Not a cure

Whether major or minor tranquilizers, these two classes of drugs are not a cure for any of the conditions they treat. They are given by doctors to relieve symptoms that are associated with other problems. Neither type of drug should be taken with alcohol, as both are depressants and can therefore compound or exaggerate the effect of the other. People who take tranquilizers also should not drive a car or operate anything mechanical for several hours after taking the pills, since they interfere with the control of a person's movements. Although technically there are major and minor tranquilizers, the word "tranquilizer" has commonly come to refer only to the minor class of drugs that treat anxiety and insomnia—probably because they are the most frequently prescribed type of drug in the world.

[See also Psychosis; Schizophrenia ]

Tranquilizers

Tranquilizers are substances that produce a state of calmness in agitated people. Minor tranquilizers—such as barbiturates —are used in the treatment of anxiety (fearfulness). Major tranquilizers are known as antipsychotics. Antipsychotics can alleviate symptoms of major psychotic illnesses (severe mental disorders that prevent patients from knowing the difference between what is real and what is fantasized). Schizophrenia (a severe disorder known for such symptoms as delusions, hallucinations, and inappropriate behavior) is an example of a major psychotic illness. In psychotic illness, normal thinking and the ability to interact appropriately with others deteriorates until patients withdraw from reality. Antipsychotics reduce the agitation and distress that patients feel, while providing the patients with emotional serenity (calmness) and indifference to what is going on around them.

Unlike minor tranquilizers, major tranquilizers of the antipsychotic type are not addictive. Patients generally do not build up a tolerance to them. Psychotic patients can take the drugs for years without needing to increase their dosage.

It is almost impossible to overdose on major tranquilizers. An overdose of barbiturates, however, can cause total respiratory arrest. Possible side effects that may be experienced with therapeutic (medicinal) use of antipsychotics include increased heart rate, dry mouth, blurred vision, and constipation.

Tranquilizers Found Useful for
Anesthesia

The tranquilizer chlorpromazine was found to be beneficial during surgery by reducing the amount of anesthetic needed. Chlorpromazine appeared to profoundly alter patients' mental awareness: patients were conscious, yet they felt quiet, sedate, and unconcerned with events occurring around them.

These effects led doctors to try chlorpromazine in the treatment of mental illness. The doctors discovered that the drug relieved psychotic episodes (which occur when a person loses touch with reality). Patients who were institutionalized (living full time) in mental hospitals in the United States began to use antipsychotics in the early 1950s. The drug chlorpromazine allowed many such patients to recover enough to leave the hospital, helping to reduce the populations of mental hospital by two-thirds in less than 25 years. For the first time a drug had been discovered that targeted the central nervous system without profoundly affecting other behavioral or motor functions.

Reserpine

American doctors also tested a drug called Reserpine on mentally ill patients. The drug did not make patients sleepy and allowed them to participate in activities.

Reserpine and other tranquilizers produce positive results. They reduce the fear, hostility, agitation, delusions, and hallucinations experienced by seriously mentally ill people. (When healthy people take these drugs, however, they experience slower thinking and react more slowly.)

Despite initially positive results, Reserpine use steadily decreased as more patients experienced a number of side effects, including reduced blood pressure, diarrhea, and depression.

Other Options

In the 1960s Belgian scientists developed a class of drugs that later became available in the United States under the names haloperidol (Halol) and droperidol (Inapsine), increasing the number of treatment options for patients with mental illnesses.

TRANQUILIZERS

The Tranquilizer Boom

In 1957 there were seventy-three brands of tranquilizers, marketed by thirty-six drug companies, available to Americans by prescription. Most of them were derivatives of the same small group of chemicals that slow down the action of the central nervous system and thus reduce nervous tension and anxiety. In 1956 physicians and psychiatrists wrote thirty-five million prescriptions for tranquilizers—a rate of one every second—and anxious patients paid $150 million to get their pills, or about $4.30 per prescription. In the mid 1950s, when tranquilizer prescriptions could be refilled indefinitely, these new drugs gained a popularity that alarmed some doctors.

Relaxation without Aftereffects

The most popular tranquilizer, generically called meprobomate, was developed in 1950 by the drug firm Ludwig and Piech from a chemical similar to antifreeze. This medicine, called Mil-town, seemed to have all the benefits and none of the side effects of the most heralded tranquilizer being tested, thorazine. Also called Equinal by the drug manufacturer Wyeth Laboratories, meprobomate was touted as a non-habit-forming cure for anxiety and nervous tension. The drug, which came in pill form, achieved its effect about forty-five minutes after ingestion. The result was a satisfying sensation caused by muscular relaxation.

Happy Pills

When they were released for distribution as a prescription drug in 1955, Miltown and Equinal were instant successes. They were prescribed for illnesses ranging from insomnia to alcoholism, but most often to people suffering from cases of "nerves." In 1957 Time (March 11) reported that a woman in Beverly Hills asked her doctor to prescribe tranquilizers for her daughter, "who needed them to get through the trying first week of her honeymoon," and a lady in Boston asked her pharmacist for a bottle of "happiness pills." Dr. David B. Allman, president of the American Medical Association in 1958, cautioned that "modern man cannot solve his problems of daily living with a pill."

IN THE PINK

Today's Health magazine reported in February 1952 that a major pill and tablet producer had come to the conclusion that Americans prefer pink pills while foreigners like brightly colored medicine. The unnamed firm offered pills in over two thousand colors and color combinations.

Sources:

"No Martinis!" Time, 69 (3 June 1957): 48;

"Facts about Tranquilizers," Consumer Reports, 23 (January 1958): 4.

tranquilizer drug whose action calms the central nervous system , decreasing emotional agitation without impairing alertness. Tranquilizing drugs differ from hypnotic drugs such as barbiturates in that they do not act on the brain's cortical areas but rather on its lower portions, e.g., the hypothalamus . They have been found helpful in the treatment of tension and mental illness. Reserpine , which appeared on the market in 1952, was the first tranquilizer to be used in modern Western medicine. Other drugs used as tranquilizers include the phenothiazines , meprobamate , certain muscle relaxants and anticonvulsants, and lithium carbonate. See also psychopharmacology .

tranquillizer Drugs prescribed to reduce anxiety or tension and generally for their calming effect. They are used to control the symptoms of severe mental disturbance, such as schizophrenia or manic depression. They are also prescribed to relieve depression. Prolonged use of tranquillizers can produce dependence and a range of unwanted side-effects.

tran·quil / ˈtrangkwəl/ • adj. free from disturbance; calm: her tranquil gaze the sea was tranquil. DERIVATIVES: tran·quil·i·ty / ˌtrangˈkwilitē/ (also tran·quil·li·ty) n. tran·quil·ly adv.

tran·quil·iz·er / ˈtrangkwəˌlīzər/ (Brit. tran·quil·liz·er) • n. a medicinal drug taken to reduce tension or anxiety.

tranquillizer (trank-wi-ly-zer) n. a drug that produces a calming effect, relieving anxiety and tension. major t. see antipsychotic. minor t. see anxiolytic.

tranquil XVII. — F. tranquille or L. tranquillus.

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