2006: A Drug to Stop Smoking

August 1, 2006 – This day, pharmaceutical company Pfizer began selling the stop-smoking drug varenicline (brand name Chantix) in the USA. Two months later it also became available in Europe (as Champix).

A Smoker

The new drug could help people to stop smoking because it both reduced the crave for nicotine, and reduced the actual effect of nicotine while smoking. Testing showed it to be more effective than drugs that had been used previously to help people quit smoking (such as the antidepressant bupropion, better known as Wellbutrin).

According to a reliable Dutch-language source, research showed that after three months of using Chantix 4 out of 10 smokers had stopped; after one year 2 out of 10 still did not smoke. So for people trying to quit smoking by using Chantix, in the long run 1 out of 5 appeared to be successful.

Serious Mental Side Effects

In 2008, the American FDA (Food and Drug Administration) noticed that this drug could cause “serious neuropsychiatric symptoms” in the form of depression, suicidal thoughts, and suicidal actions. In July 2009, the FDA required Pfizer to print a “Black Box” on Chantix packages to clearly warn for this side effect.

Chantix is still being promoted actively for people who want to stop smoking, but the Pfizer website for health care professionals now includes a clear warning of the risks. They even mention that some Chantix users were reported to have “completed suicide”:

 
“All patients being treated with CHANTIX should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide. These symptoms, as well as worsening of pre-existing psychiatric illness and completed suicide have been reported in some patients attempting to quit smoking while taking CHANTIX in the post-marketing experience.
   [...] Advise patients and caregivers that the patient should stop taking CHANTIX and contact a healthcare provider immediately if agitation, hostility, depressed mood, or changes in behavior or thinking that are not typical for the patient are observed, or if the patient develops suicidal ideation or suicidal behavior.”
 

The official Pfizer webpage for consumers offers similar warnings, though perhaps a little less prominently displayed:

 
[...] “Also tell your doctor about any history of depression or other mental health problems before taking CHANTIX, as these symptoms may worsen while taking CHANTIX.”
 

Beelzebub?

To be honest, I’m reminded of an old German saying here: “den Teufel mit Beelzebub austreiben”, expelling the devil by Beelzebub. This applies when you try to combat one evil with an equally bad evil.

devil-and-deathDevil and Death, detail from “Allegory of Law and Grace”,
after a 1530 woodcut by Lucas Cranach the Elder

Unlike most histories presented here, this one is clearly not finished yet.

 


1798: Carl Blechen

Another Mad Artist

July 29, 1798 – Birth date of Carl Blechen (full name Carl Eduard Ferdinand Blechen). He would become one of the most important German Romantic landscape painters of the early 19th century, but his life would be cut short by serious mental illness.

Here is the selfie he made in 1825:

Self-portrait Carl Blechen

Around 1830, making study trips to the Baltic Sea and Italy, Blechen was very productive and since 1831 he also taught landscape painting at the Berlin Academy of Arts.

More than some other romantic landscape painters, Blechen focused not just on pure-nature vistas but also on cultural, man-made elements. For example in this 1832 painting, the interior of the “Palm House” at the Pfaueninsel park in Potsdam:

Palm House, by Carl Blechen

Unique was how in several of his works, he also painted the manifestations of the early-19th century first wave of industrialization.

In the about 1830 landscape below, the central element was not some romantic castle but the Neustadt-Eberswalde sheet metal mill, towering over the stream that now served as its industrial waste sewer.

Eberswalde Mill, by Carl Blechen

Blechen already suffered from depressions throughout the 1830s. In 1836, he was struck by a depression that was so severe and paralyzing that he had to be put in an asylum. In 1837 he briefly appeared to recover, making a short trip to Dresden, but after that he would produce no more paintings and drawings: his mental health kept deteriorating.

Exactly what was wrong with him is not clear, but according to contemporaries he increasingly began to suffer from very strong and recurring hallucinations, too. In July 1840, when he was nearly 42, Blechen died “in geistiger Umnachtung”: in a state of mental derangement.

The exact circumstances of his death are unknown. Even the exact location of his grave at the Berlin Dreifaltigkeitskirchhof II (Trinity Cemetery) was forgotten: he is now commemorated with an inscribed stone in the cemetery wall.

Almost needless to say, today many of Blechen’s works can be found in major art collections and museums.

 


1910: Eduard Einstein

July 28, 1910 – This day Mileva Maric, wife of physicist Albert Einstein, gave birth to the couple’s second son: Eduard Einstein. The 1914 photo below shows him as a toddler with his mother and his older brother Hans Albert. It was taken about the time his parents separated; they formally divorced when Eduard was eight.

Eduard Einstein (4) with mother and brother

Eduard, nickname “Tete”, soon proved to be a very intelligent and talented boy. He read a lot and came to adore Freud, wanting to become a psychiatrist himself.

However, in his late teens he developed mental problems, suffering from psychotic episodes. At 20, having been placed by his mother in the famous Burghölzi psychiatric clinic in Zürich, Eduard was diagnosed with schizophrenia.

Father and Son

We all know that Albert Einstein was a brilliant scientist, but as a husband and father he failed miserably. He left the daily care for Eduard to his ex-wife and saw his son only rarely.

The photo below was taken in 1933 when the already famous physicist, before leaving to settle in the United States, visited Eduard. It was the very last time the two saw each other. Albert Einstein, who died in 1955, would never visit Eduard again.

Eduard Einstein with his father

It looks like Einstein simply did not know how to handle his son’s mental illness. He once wrote that Eduard was his “single unsolved problem” and he is reported to have said that if he had known everything in advance, he would not have let Eduard be born.

For most of his life Eduard would remain under the care of his loving mother, with intervals in foster families and in the Burghölzi clinic. After Mileva’s death in 1948, Eduard came to live in the clinic permanently. Below is one of the last photos taken of him. He died from a stroke in the same clinic at the age of 55, in 1965.

Eduard Einstein

Looking Back

The first effective antipsychotic drugs (most notably, Thorazine) had gradually been introduced in the late 1950s but unlike later medication, these still could have fairly severe side effects.

According to older brother Hans Albert, what had really ruined Eduard’s mental and physical health was the overuse of therapies with far too heavy medication – and especially the very intensive use of electroshocks. Looking back, it is hard to establish if this judgment was correct but he may well have been right.

Today, the Burghölzi psychiatric clinic in Zürich still looks the same as in Eduard’s time:

Burghölzi psychiatric clinic, Zürich

Footnotes:

  • The Shapell history website has a brief letter written in December 1934 by Albert Einstein to Eduard. In this letter, sent to Zürich from Princeton, the father told his son that he was glad to hear that new treatments appeared to help; that he didn’t write him often because he had little to tell, but that he did think of him often.
  • In 2013, French physician-and-novelist Laurent Seksik wrote a historical novel about the tragic life of Eduard Einstein: Le cas Eduard Einstein. The book has already been translated into German (Der Fall Eduard Einstein) and Italian (Il caso Eduard Einstein). As far as I know (writing this in July 2014) there is no English-language edition yet.

 


1938: John William Warde

Suicide as a Spectacle

July 26, 1938 – Today, clinically depressed John William Warde (26) kept New York in suspense for hours while standing precariously on the 17th floor window ledge of the New York Gotham hotel, hesitating about killing himself. Thousands of onlookers (plus about 300 policemen and several press photographers) gathered on the street corners below.

Police and firemen kept trying to talk him back in, but (afraid he would jump if they tried to get a hold on him) they didn’t dare to touch him.

john-warde-1

From the next window his sister (photo above) pleaded with him; a psychiatrist tried talking to him while giving him a drink with some tranquilizers dropped in, and a policeman kept a friendly conversation going for hours on end.

Warde was given coffee, cigarettes, and handed a telephone horn to talk to his mother on the line. Nothing helped to get him back inside.

In the evening, when Warde had stood for 11 hours on the ledge, firemen began to rig up a safety net from the windows just below him. Minutes before the net was pulled in place, Warde suddenly took his fatal plunge. Bouncing off the hotel’s entrance marquee, he fell to his death on the sidewalk.

Everything was photographed.

john-warde-2

john-warde-3

Film

The dramatic combination of suspense and desperation left such an impression, that in 1951 20th Century Fox made a full-length movie about it. Originally it would be titled The Man on the Ledge but on request of Warde’s mother, the title was changed to Fourteen hours.

The film was made with two alternative endings. Initially the makers wanted it to end in the same dramatic way as the real story.

In a twist of fate, on the very same day this first version was previewed, the daughter of Fox president Spyros Skouras jumped to her death. He wanted the film shelved, but half a year later it was released with a more positive ending (the man on the ledge surviving).

john-warde-4

Footnotes:

  • It remains a mystery exactly what medication the psychiatrist tried to give Warde to calm him down. Modern tranquilizers such as Valium did not yet exist. The most used tranquilizers in the 1930s were barbiturates, but these would have been too dangerous in this situation: they had such a sedating effect that they could easily have caused Warde to fall off the ledge by accident.
  • A full photo report was published two weeks later by Life Magazine. Google Books has this August 8, 1938 issue of Life online – scroll down about one-third of that webpage to see the original Life pages covering Warde’s dramatic suicide.
    With their many photos, the Life journalists used suggestive subtitles such as “A lunatic comes down to earth” and “New York crowds gape up as young lunatic leisurely ponders his dive to death”. In other words, they described Warde as an insane rather than as a depressed person.
  • Amazon offers a DVD with the 1951 film about Warde: 14 Hours.

 


1972: Prozac Discovered

July 24, 1972 – This was the day when Chinese-American neuroscientist David T. Wong (36) while testing a new compound (fluoxetine) in the lab of pharmaceutical company Eli Lilly & Co., came to the conclusion that it might make an effective antidepressant by regulating brain serotonin levels. It would make him famous.

David Wong

Wong had started this particular thread of research on his own initiative, without asking the company’s consent. As he told later, “I didn’t even tell management that I started until I got going.”

He first published about his fluoxetine discovery in 1974, and the next year Ely Lilly gave it the brand name Prozac. Larger-scale testing started in 1976, and Prozac was patented in 1982.

Sales finally began in January 1988, over 15 years after the initial laboratory breakthrough. From the beginning, the new product was intensively promoted with campaigns aiming both for psychiatrists and other physicians, and the general public. Here is an early campaign image:

It Delivers (early campaign image)

As the first available drug in the SSRI class (selective serotonin re-uptake inhibitor) Prozac soon became one of the best-selling antidepressants ever. For many depression patients, it replaced less effective drugs such as the tranquilizer Valium.

A Kind of Emblem

“Prozac” soon became a household name. In 1994, just six years after its appearance on the market, it was already so well known that Elizabeth Wurtzel could give her 1994 autobiographical novel about being “young and depressed in America” the emblematic title Prozac Nation.

Prozac Nation

Many people (including me) think that in the past decades Prozac has sometimes been over-prescribed to patients who might have been better off with less medication or even none at all. Still, it’s obvious that Wong’s discovery did not just generate huge profits for his employers. It probably did save a lot of lives as well.

Footnote:

 


1955: Eve Miller

July 21, 1955 – On this day, mentally unstable Hollywood actress Eve Miller (31) stabbed herself in the abdomen after discovering that her lover, actor Glase Lohman, did not want to marry her. She was found in a pool of blood on her kitchen floor.

Eve Miller in Big TreesEve Miller on a publicity photo for The Big Trees, 1952

Miller was a not-yet famous but certainly rising star; between 1948-1955 she had figured in nine films. Her best known roles had been in the westerns The Big Trees (with Kirk Douglas, 1952) and Kansas Pacific (with Sterling Hayden, 1953). In 1954, she had a minor role (along with Marilyn Monroe) in the musical There’s No Business Like Show Business.

She barely survived her suicide attempt; four hours of emergency surgery were needed to save her life. Here is an example of how newspapers covered it:

Eve Miller Stabbed Self

Never Fully Recovering

After her 1955 suicide attempt Miller would never play in another major film again.

She continued to appear in various TV series such as Lassie until the early 1960s. In the end, however, she lost her battle against depression and disappeared from the scene altogether. It is unclear if she ever tried to seek psychiatric help for her mental problems.

Eve Miller with Kirk Douglas

The End

In August 1973, a week after her 50th birthday, she tried to kill herself once again. This time she did not survive.

Footnote:

  • The newspaper clipping is from the July 22, 1955 Lewiston Evening Journal as archived by Google. It demonstrates that although Miller’s suicide attempt was a news item, she was not yet a really prominent actress.
    The journalist’s assertion that her true name was Marilyn Miller, was mistaken: actually her birth name was Eve Turner.

 


1913: the Feeble-Minded

Locking Them Up

July 19, 1913 – On this date, the British Parliament passed the Mental Deficiency Act. It came into effect a few weeks later, on August 15. This law was introduced because the previous one, the 1886 Idiots Act, was thought to be covering not enough deviant people.

The new law was described as “An Act to make further and better provision for the care of Feeble-minded and other Mentally Defective Persons and to amend the Lunacy Acts.” To the older law’s categories of “Idiots” and “Imbeciles” it added two new categories: the “Feeble-minded Persons” and the “Moral Imbeciles”.

Here is one of the targeted people, photographed in 1908. We don’t know his name but he was a really bad case, according to the original photo subscript: “A mentally instable imbecile suffering from melancholia.

Melancholic imbecile (1908)

Feeble-minded Persons” were those “whose weakness does not amount to imbecility, yet who require care, supervision, or control, for their protection or for the protection of others”. This definition was so wide that it could apply to any kind of serious mental problem or illness.

Moral Imbeciles” were in fact all those who could or would not conform to accepted standards of social decency and responsibility. The kind of people whose behavior disturbed respectable citizens. This group was defined as anyone “displaying mental weakness coupled with strong vicious or criminal propensities, and on whom punishment has little or no deterrent effect”.

If any of these people “had been abandoned, neglected, guilty of a crime, in a state institution, habitually drunk” they could be legally locked away. In daily life, this also meant that forced institutionalization could be applied easily to people whose deviant behavior was in fact caused by mental illnesses such as schizophrenia or long-term deep depression.

Here is another one of the target group. Original 1908 subscript: “A pronounced imbecile; quiet and well-behaved, but idle and untidy.

Untidy Imbecile (1908)

Result

In the interwar years (1918-1939) over 60,000 English people with very different problems were locked in institutions under this law. Some of them probably for their own good, but there also were many lock-ups that we today would find questionable.

With some modifications, the law remained in effect until 1959. Here is the official form that doctors used in the 1950s to lock someone in an institution. It still referred to the 1913 Mental Deficiency Act:

Lock-away Form (1950s)

Footnote:

  • The patient portraits (and the subscripts) are from a 1908 book by the London doctor Alfred Frank Tredgold (1870-1952), an important expert who was active in the National Association for the Feeble-minded, and as adviser for the Royal Commission on the Feeble-minded that helped prepare the 1913 law. He had started his career as an asylum doctor.
     
    Tredgold’s book contained a whole series of portraits of what he considered typical “feeble-minded” patients. To see them all, download the book as a PDF from archive.org: A.F. Tredgold, Mental deficiency (amentia), published New York 1908.

 


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