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The Age of AnxietyReview - The Age of Anxiety
A History of America's Turbulent Affair with Tranquilizers
by Andrea Tone
Basic Books, 2009
Review by Leo Uzych, J.D., M.P.H.
Sep 29th 2009 (Volume 13, Issue 40)

The Age of Anxiety chronicles meticulously the checkered history of the use of tranquilizers in America.  The author, Dr. Andrea Tone, is the Canada Research Chair in the Social History of Medicine, at McGill University.  An adept with a writing instrument, Tone pens her discourse in a style notable for its beauty as well as power.  Tone's substantive exposition of the historic use of tranquilizers by Americans is empowered greatly by her blunt candor, critical acumen, and deep reservoir of knowledge.  While traversing the path followed historically, by tranquilizers in America, Tone expounds expertly on tranquilizers as a major medical phenomenon, and, also, on their massive insinuation into myriad cultural, social, and political crevices of American life.  The superlative writing of Tone will likely render the reader spellbound; and certainly, Tone's brilliant writing efforts contribute importantly to the literature of the history of American medicine.

To the likely intellectual delight of academically inclined readers, the book's substantive contents are edifyingly research referenced.  Citations for a vast multitude of referenced research materials (including some which are annotated briefly) are given in the "Notes" section, joined structurally to the text's far end.

A bevy of visual images, germane to the adjoining text and accompanied typically by pithily worded explanatory material, are grafted into the book's substantive body.  This structural feature contributes further to the book's composite educational value.

The highly skilled recounting by Tone of the history of the use of tranquilizers in America is characteristically very insightful as well as engagingly informative.  The sharply discerning writing blade wielded by Tone also cuts a considerably wide swath of historic ground.

Falling conspicuously within the broad sweep of Tone's writing scythe is the professional work of medical scientist Dr. Frank Berger.

In enthralling fashion, Tone describes:  the serendipitous  discovery, by Berger, of the tranquilizing properties of a drug called mephenesin; Berger's snaring of a drug called meprobamate, while trolling for an orally active, longer lasting variant of mephenesin; and the classification of meprobamate  as a "tranquilizer", and its branding as the drug called "Miltown".

Tone guides the reader very capably along the early historic path of Miltown, as it passes through Hollywood and acquires celebrity fetish status; and later, as the little white, antianxiety pill makes major inroads into mainstream America in the 1950s, as a hoped for antidote for frayed nerves.  In earnest search of understanding of the Miltown phenomenon, Tone examines the anxiety inducing political dynamic of that time era, as well as the tidal wave of consumerism sweeping across America in the 1950s.  There is likewise instructive comment on the diverse demographic use of Miltown, in the 1950s, in contrast to the later (in the 1960s) gendering of the tranquilizer market.

Although the engine of the newly emergent psychopharmacologic revolution in mainstream America was fueled, in significant part, by Miltown, the swelling river of tranquilizer use in America had multiple tributaries.

One of these tributaries is "Equanil" (the "other meprobamate").

Another tributary followed by Tone, with regard to the burgeoning flow of psychopharmacology in America, is the drug chlorpromazine (branded as "Thorazine").

The story of America's historic use of a class of antianxiety drugs called benzodiazepines additionally attracts the rapt attention, of Tone.  Of  particular interest are the benzodiazepines branded as "Librium" and "Valium", together with extensive comment on their inventor, Hoffman-La Roche scientist Dr. Leo Henryk Sternbach.

The issue of tranquilizer safety falls sharply within the sight of Tone's panoramic view of tranquilizers, history, and America.  Drawing particular focus, in this regard, is the growing societal apprehension in the 1970s concerning dependence and addiction problems associated possibly with the use of tranquilizers.

The intellectual flashlight of Tone shines illumining light on America's historic struggles to place legal and regulatory shackles on tranquilizers with the intention of restricting perceived inappropriate use, albeit without interfering with the use of tranquilizers in overly Draconian manner.

The intellectually enlightening discourse of Tone extends also to revealing examination of a confluence of diverse American forces (entwining political, social, economic, medical, and cultural strands) impacting the feminization of tranquilizers as well as evolving societal perceptions regarding women and tranquilizer use.

The research expertise and enviable writing excellence of Tone, on display conspicuously and continually in this very fine book, should absorbingly attract the interest of a broad range of professionals, including:  medical historians, psychopharmacologists, pharmacists, pharmaceutical industry professionals, psychiatrists, neurologists, primary care physicians, internists, neuroscientists, biochemists, drug addiction specialists, drug counselors, public health professionals, and health policy makers.


© 2009 Leo Uzych


Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University.  His area of special professional interest is healthcare.


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