How was amphetamine introduced to the world medical market?
For me, one of the most interesting stories is how they decided what the clinical use of amphetamine was going to be. In other words, what market to target within medicine. How to make it a successful prescription drug. Then, not so different from now, drug companies had an extensive network of connections with important physicians, academic medical researchers, and they'd manage clinical trials through these experts. And the experts would receive money, and would generally involve right of veto over publication. So if a trial was unsuccessful, it made the drug look bad, you would never see a result. And this is recognized as a big problem in the medical literature today, that drug companies have too much control over clinical trials. Anyway, it wasn't perceived as a problem then. They ran it through clinical trials for all kinds of stuff. Bed wetting. Cognitive enhancement, particularly for kids who were scoring low in school. They ran it for dysmenorrhoea, painful menstruations, sort of like PMS. Obviously a very common disorder. And the experts that were most interested were psychologists and neurologists. It turned out to be good for narcolepsy. Of course ephedrine was already being used for narcolepsy. That's a condition where you fall asleep involuntarily, and so something that keeps you awake is good. It was used for certain kinds of Parkinsonism with some success. Possibly quite similar to the effects that you get with MS today. But most exciting for its commercial prospects, depression. There was an expert on depression at Harvard University Medical School and Tufts Medical School at the time named Abraham Myerson. He was a very well-recognized psychiatrist. He wrote popular best sellers. He had some unorthodox views on depression. For at least 10 years, he had been pushing a new view of depression that it was fundamentally rooted in the lack of pleasure, lack of pursuit of pleasure, anhedonia. And when he tried amphetamine on patients, and seeing depression through this lens of anhedonia, he saw it as a miracle drug. It made people pursue pleasure more. It made them more lively and interested in the world around them.
