Happy Pills in America from Miltown to Prozac by David Herzberg (review)

Happy Pills provides readers, especially college-level students, with an excellent historical introduction to the subject of mood-altering prescription drugs as used in the United States in the post-World War II era. Herzberg's clear and readable prose masks in part the depth of his understanding and analysis of the topic. In addition to its classroom potential, this is a serious book with valuable insights for scholars in the field. It succeeds in showing that the history of pharmaceuticals reveals more about the people involved than about the drug molecule and its dosage form. For Herzberg, psychoactive medicines are best understood as another component of the postwar "American Dream" alongside suburbia, household appliances, and automobiles. The author ambitiously links the changing pharmaceutical landscape with social movements such as feminism and consumerism. Moreover, he does not shy away from attempting (with much success) to bridge the gap between the parallel narratives of licit and illicit psychoactive substances in the United States. In part, he succeeds by avoiding the common trap of evaluating the safety and efficacy of this class of drugs. Instead, he pursues their stories as technological innovations with consequences.

Divided into five chapters plus a pithy eleven-page conclusion, Happy Pills addresses its subject in chronological fashion. Chapter 1 looks at the beginnings of psychotropics in the 1950s and 1960s. Miltown (meprobamate) is the featured player as the first postwar blockbuster antianxiety drug. In this chapter, Herzberg provides a solid brief overview of the prewar pharmaceutical trade. We learn about how Miltown and Valium (diazepam) meshed with the dominant talk therapy paradigm of the era.

Chapter 2 "Listening to Miltown" in actuality looks at the place of antianxiety medicine in the cultural changes of the late 1950s and early 1960s, especially the antitranquilizer arguments of Betty Friedan and other feminists. In his analysis of advertising for antianxiety drugs, Herzberg expands the usual narrative by examining how tranquilizers were marketed differently for men.

In Chapter 3, Herzberg discusses the relationship between campaigns against "drugs" and increasing concern within the medical community about the addictive nature of "happy pills." As in other parts of the book, the author does an excellent job providing concise historical background to the issue at hand, in this case, the changing concept of addiction and the increased regulation of addictive drugs and medicines.

The Valium panic is the focus of Chapter 4. In the late 1970s, public opinion turned on Valium very quickly. In the previous chapter, Herzberg outlined how diazepam and similar drugs were evaluated and regulated by government authorities. Here he documents the growing panic exemplified by the cases of Betty Ford and television producer-author Barbara Gordon (I'm Dancing as Fast as I Can, New York, Harper & Row, 1979). As throughout Happy Pills, the emphasis is on Valium the manufactured and marketed pharmaceutical as much as diazepam the psychoactive drug substance.

Chapter 5 moves forward in time to the 1980s when the "age of anxiety" handed the baton to the "age of depression." Psychiatry, once fascinated with childhood trauma and resulting neuroses, shifted to concern over brain chemistry and neurotransmitters. A new class of antidepressants, the selective serotonin reuptake inhibitors, entered the market offering relief to millions of depression sufferers. Herzberg discusses at length Peter Kramer and his bestselling book, Listening to Prozac (New York, Penguin Books, 1993). And he makes an intriguing comparison between the general acceptance of Prozac in the 1980s and the condemnation of "crack-heads" and "crack-moms" in the media.

In his conclusion, Herzberg writes that to "place human action, rather than drug action, at the heart of this story pulls the history of drugs and medicines out of its isolation and back into contact with other broad developments in postwar American" (197). Happy Pills does this well and thereby earns a place on the shelf next to Mickey Smith...