Perspectives in Biology and Medicine

LETTERS TO THE EDITOR Dear Sir: It may seem strange at first sight that in a stoned age of drugged individualism it is nearly impossible for the average man to obtain sensible and meaningful information about psychotropic drugs. But what kind of information about witches was available during the Inquisition? These have been and evidently still are "burning " questions, and the spiritual belief system and praying unity of the Western medieval world can now be contrasted with the "objective" Utopian belief system of our "progressive" drug-taking society. My concern is the credibility gap with respect to what drugs do and don't do. As an example, for years we have been told, first through scientific journals and then via the mass media, that LSD produces chromosomal damage and malformation in the newborn. Although the chromosomal damage story is unfounded [1], the average "well-informed" citizen still does not know what to believe since the mass media do not give the same coverage for refutation as for the dissemination of the original sensational, but false, claim. In retrospect, it appears that the LSDinduced chromosomal damage story was conceived by internationally unknown puritans whose intentions were to eradicate illicit LSD-taking. In a similar vein, our puritanic ancestors tried unsuccessfully to discourage masturbation, which was supposed "to rot away the spine." In fact, the motto of all these crusaders was but another variation on an old theme; the God of the Old Testament already invoked the threat of chromosomal (genetic) damage: "For I the Lord am a jealous God, visiting the inequity of the fathers upon the children unto the third and fourth generation of them" (Exodus 20:5). If the purported LSD-damage was a typical example of overreporting, the victorious saga of successful psychochemotherapy with the major tranquilizers could be called an underreporting. For years we were made to believe that the discovery of these drugs revolutionized psychiatry and that the tranquilizers enabled millions of patients to spend less time in mental hospitals and to live "normal" lives within the community. A factual appraisal, however, reveals that these pills are beneficial only to some and detrimental to others, whereas in the majority of cases they only delay mental deterioration. This is reflected in what has been called the "revolving door" phenomenon: patients are being hospitalized for shorter periods than previously, but they are also being more frequently readmitted [2]. Although tranquilizers may help to produce "a less demanding and complaining patient," they can induce irreversible brain damage, as long-range experiments suggest [3]. Cytological examination of the brains of rats fed Thorazine® at various dose levels and sacrificed at various time intervals shows that certain animals suffered irreversible brain damage. In translating their data from rat to man, die authors warn that irreversible brain damage may be expected to occur in man if more than 400-500 mg Thorazine® (the most widely used tranquilizer 474 J Letters to the Editor in üie Western world) is administered daily to patients for an extended period of time. We can indeed verify this prediction by visiting the chronic wards of any state mental hospital. They harbor a considerable number of patients—perhaps hundreds of thousands in the whole country—who were given 800-2,000 mg of Thorazine ® daily, year after year, and who now display the unmistakable signs and symptoms of tardive dyskinesia, the consequences of tranquilizer-induced irreversible brain damage. The involuntary, stereotyped movements of these patients in the oral area and die ticks of their hands and feet persist even after the drug "treatment" has been terminated. This kind of drug abuse is largely unknown to the public, since it is disguised as a side effect of successful psychochemotherapy. It is not realized that there is no such thing as psychochemotherapy, especially if we substitute the poetic term "psyche" with the more operational "cortical activity." In man the set, setting, personality, and expectations based on past experience determine the cortical, that is, perceptual-behavioral (or cognitive) interpretation of drug-induced changes in his subcortical activity. In fact, except for the anesthetics and hypnotics, psychotropic drugs act mainly, if not exclusively, on subcortical structures, and there is no drug which...