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Logo of medhistThe Wellcome Trust Centre of the History of Medicine (UCL)Medical History
Med Hist. 2010 July; 54(3): 428–429.
PMCID: PMC2889483

Book Reviews

Happy pills in America: from Miltown to Prozac
Reviewed by Alex Mold

David Herzberg.
Happy pills in America: from Miltown to Prozac,  Baltimore,  Johns Hopkins University Press,  2009, pp.  x, 279, £24.00, $45.00 (hardback  978-0-8018-9030-7) 

The reader of almost any American magazine cannot help but be struck by the number of advertisements for branded pharmaceutical drugs that feature within its pages. Although direct to consumer advertising has only been permitted in the US since the 1990s, this was a development, rather than a revolution, in the way in which pharmaceutical drugs were marketed. As David Herzberg reveals in his excellent book, promotional campaigns for “blockbuster” drugs like Miltown, Valium, and later Prozac, were always designed to leak out of the doctors’ surgery and into the waiting room. By promising to cure a vast range of conditions including fatigue, social unease, pre-exam nerves and sexual frigidity, psychotropic drugs were marketed as the solution to many of the problems confronting the anxious post-war consumer. Little wonder then, that by the 1970s, Valium was the most prescribed brand of medicine in the US, with 15 per cent of Americans using it within the previous year.

Yet the reason that Valium and other “happy pills” took such a hold of doctors and their patients was not just because these seemed to offer a panacea, but also because the promotion of these drugs tapped into a whole host of other concerns. Herzberg shows how anti-anxiety drugs were marketed as miracle products that could return men, and particularly women, to the good life. Advertisements which focused on tranquilisers’ supposed ability to make men more effective at work, and help women be more efficient in the home, simultaneously drew on and reinforced ideas about “traditional” gender roles. However, challenges to such assumptions in the late 1960s and early 1970s led to a backlash against Valium. Feminist groups argued that the drug operated as an agent of social control, medicating women into the acceptance of a subordinate position within society. At the same time, scientists began to assert that Valium could be addictive, an idea that called into question easy distinctions between the drugs found in the medicine cabinet and those found on the street. The potential harm that “happy pills” could cause eventually resulted in a reformulation of the Schedule of Controlled Substances, and though pharmaceutical companies managed to ensure that their drugs were subjected to the lowest levels of control, or excluded from the schedule entirely, the boundary between licit and illicit drugs was exposed as being culturally, rather than scientifically, defined.

Indeed, it is one of the great strengths of Herzberg’s book that pharmaceutical psychoactive drugs are considered in relation to their contraband cousins. The histories of legal and illegal drugs have often been analysed separately, when in reality these are frequently inter-related stories. Neatly sidestepping debates about whether or not “happy pills” actually work, Herzberg concludes that what matters is not the chemicals that make up these drugs, but the people that develop, sell, prescribe and use these. As a result, Happy pills offers much more than a study of the rise and fall of anti-anxiety and anti-depressant drugs: Herzberg shows how these substances provide a lens through which much wider changes in post-war America can be examined. The rise of commercial medicine and the consumer society, the remaking of the modern self, changing gender, race and class relations all form part of this complex picture. This extremely well-written and well-researched book thus demands, and deserves, a wide audience.

Articles from Medical History are provided here courtesy of Cambridge University Press