What Was Dexamyl?
Dexamyl was a brand-name pharmaceutical product introduced by Smith, Kline & French (SKF) in 1950. The medication was a fixed-dose combination of two active ingredients: dextroamphetamine and amobarbital. This pairing was intentionally designed to address perceived shortcomings of using amphetamines alone for conditions like depression. Dextroamphetamine, a central nervous system (CNS) stimulant, was intended to elevate mood and suppress appetite. However, its stimulating effects often caused unpleasant agitation and anxiety in users. To counteract this, the sedative barbiturate amobarbital was included. The combination was intended to provide a mood-elevating effect while minimizing the agitation associated with the stimulant component alone.
The Rationale Behind the Combination Drug
The creation of Dexamyl followed the earlier marketing of amphetamine as an antidepressant under the brand name Benzedrine. The market rationale for adding amobarbital was to create a more balanced psychopharmaceutical. At the time, Dexamyl was seen as a way to provide therapeutic benefits without the extreme agitation and anxiety that sometimes accompanied amphetamine use. The combination's perceived ability to offer a "calm" mood lift without inducing indifference made it an appealing option for clinicians managing patients with both depression and anxiety.
Medical Uses and Indications
Historically, Dexamyl was prescribed for a range of conditions, often targeting symptoms related to mood and energy levels. Its primary indications included:
- Mental Depression: Used to elevate mood, dispel apathy, and increase initiative in patients experiencing mild depressive states.
- Obesity: Prescribed as an appetite suppressant, addressing both the physical and emotional aspects of overeating.
- Anxiety: The inclusion of amobarbital was meant to specifically address anxiety and tension.
The Rise and Fall of Dexamyl
During the 1950s and 1960s, Dexamyl enjoyed significant commercial success and was widely prescribed. Its popularity extended beyond therapeutic use into a bustling subculture of recreational abuse. In Britain, the drug became a staple among youths, earning the nickname "purple hearts" for the shape and color of its triangular tablets. The colorful spansule capsules were also known as "Christmas trees" on the street.
Noted individuals also had links to the drug. For example, British Prime Minister Anthony Eden was reportedly using Dexamyl for a medical condition during the Suez crisis, with some historians suggesting it impaired his judgment. The drug's addictive potential and widespread abuse were a growing concern. Regulatory bodies in the U.S., like the FDA and DEA, began scrutinizing amphetamine-containing diet drugs, culminating in a broader crackdown on their availability.
Discontinuation from the Market
By the late 1970s and early 1980s, the landscape of psychopharmacology had evolved significantly. Newer, safer, and more effective treatments for depression, such as monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs), became available. These medications did not carry the high risk of dependence and abuse associated with Dexamyl. Facing increasing regulatory pressure and competition from superior alternatives, SKF discontinued Dexamyl in 1982.
Comparison of Dexamyl to Modern Alternatives
| Feature | Dexamyl (Historical) | Modern ADHD Stimulants (e.g., Adderall) | Modern Antidepressants (e.g., SSRIs) |
|---|---|---|---|
| Composition | Dextroamphetamine + Amobarbital | Mixed amphetamine salts | Selective serotonin reuptake inhibitors |
| Primary Uses | Depression, obesity, anxiety | ADHD, narcolepsy | Depression, anxiety disorders |
| Abuse Potential | High; contains a stimulant and a barbiturate | High; DEA Schedule II controlled substance | Low; non-addictive |
| Side Effects | Agitation (countered by sedative), dependence, withdrawal symptoms | Increased heart rate, blood pressure, insomnia, risk of psychosis | Nausea, weight changes, sexual dysfunction, headache |
| Status | Discontinued | Currently available (generic and brand names) | Currently available (widely prescribed) |
Dangers, Abuse, and Addiction
The dual nature of Dexamyl—a stimulant and a sedative—contributed to its high potential for abuse and dependence. This combination created a unique set of risks that led to serious health consequences for many users. The stimulating effects of dextroamphetamine could lead to psychological dependence and abuse, while the sedative effects of amobarbital also carried a risk of physical dependence.
Misuse of Dexamyl could lead to a range of severe side effects, including overdose, amphetamine psychosis (characterized by delusions and paranoia), and significant cardiovascular complications. Withdrawal from the drug, especially after prolonged, heavy use, could produce symptoms such as fatigue, depression, and anxiety. The combination's ability to mask the stimulant's negative effects with a sedative made it particularly appealing for recreational use but dangerously addictive in practice.
Modern Perspectives and the Legacy of Dexamyl
Today, Dexamyl serves as an important case study in pharmacology and the history of medicine. Its discontinuation highlights the evolution of pharmaceutical standards, prioritizing patient safety and efficacy over potentially dangerous drug combinations. The lessons learned from Dexamyl's rise and fall informed the development of more targeted and safer psychotropic medications now used to treat conditions like depression, anxiety, and ADHD. Contemporary treatment protocols rely on a more nuanced understanding of neuropsychopharmacology, offering a wider array of medications and therapies tailored to individual needs, with significantly reduced risks of dependence and abuse. For more information on the history of amphetamine use and abuse, a detailed overview can be found on PubMed Central regarding America's first amphetamine epidemic.
Conclusion
Dexamyl was a historical combination drug of dextroamphetamine and amobarbital, created to treat depression and obesity by providing a mood-elevating effect with less of the agitation associated with stimulants alone. However, its high potential for abuse, dependence, and significant side effects ultimately led to its discontinuation in the early 1980s. The drug's legacy underscores the importance of stringent safety regulations and the continuous evolution of safer, more effective treatments in modern medicine. Today, safer alternatives exist for the conditions Dexamyl once treated, reflecting a deeper understanding of therapeutic pharmacology.
