A mid-century remedy for mental and emotional distress
In the post-war era, psychiatric medicine was undergoing a significant transformation. As the pharmaceutical industry grew, companies sought new ways to address mood disorders, fatigue, and weight issues. This landscape led to the creation of Dexamyl in 1950 by Smith, Kline & French (SKF). It was marketed as a revolutionary treatment for everyday "mental and emotional distress" and proved a commercial success for over two decades.
The composition of Dexamyl was central to its supposed innovation: a blend of dextroamphetamine, a potent stimulant, and amobarbital, a barbiturate sedative. The dextroamphetamine was intended to elevate mood and suppress appetite, while the amobarbital was meant to counteract the potential agitation, jitteriness, and insomnia associated with the stimulant. This "balanced" approach was what the manufacturers promoted as a more tolerable alternative to pure amphetamines, which had already gained notoriety for their intense side effects.
The primary uses for which dexamyl was prescribed
Depression
One of the main indications for Dexamyl was the treatment of mental depression. In the mid-20th century, before the development of modern antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs), treatment options for depression were limited. Amphetamines alone, such as Benzedrine, had been used since the late 1930s as antidepressants, but their side effects were often unpleasant. Dexamyl's combination formula promised the mood-lifting effects of dextroamphetamine without the intense agitation, making it an attractive option for both physicians and patients.
Obesity
Another major use for Dexamyl was as a diet drug, targeting obesity. The dextroamphetamine component is a powerful anorectic, meaning it suppresses appetite. When the medication was introduced, obesity was primarily viewed as a willpower issue, and appetite suppressants were seen as a legitimate medical solution. Dexamyl’s mood-elevating effect was also thought to be beneficial for those struggling with the emotional causes of overeating. However, this application was later heavily restricted and eventually deemed unsafe due to the high risk of dependence and limited long-term efficacy.
Anxiety
While dextroamphetamine is a stimulant, the inclusion of the sedative amobarbital made Dexamyl a dual-action drug also used to address anxiety. The theory was that the barbiturate would calm the user, mitigating the potential for the stimulant to induce anxiety, restlessness, or agitation. This made it a popular prescription for "anxiety" and other forms of psychological distress, especially among housewives in the 1960s who were famously over-prescribed the medication.
The dangerous consequences and discontinuation
Despite its initial popularity, Dexamyl's severe side effects, high abuse potential, and dependence liability soon became apparent. Both of its active components carry significant risks:
- Dextroamphetamine: Can lead to increased heart rate, elevated blood pressure, insomnia, and psychological side effects like anxiety, paranoia, and psychosis. Long-term, high-dose use can cause permanent changes to the brain's dopamine system.
- Amobarbital: As a barbiturate, it carries a high risk of dependence and can be lethal in overdose, especially when combined with other central nervous system depressants like alcohol.
The high potential for abuse made Dexamyl a popular street drug, known by illicit names like "purple hearts" for its triangular blue tablets. Reports of addiction, overdose, and psychological disturbances grew, raising serious regulatory concerns. Prominent cases of abuse involving figures like British Prime Minister Anthony Eden and musician Jerry Lee Lewis brought the drug's dangers into public view.
By the late 1970s and early 1980s, regulatory bodies and physicians had access to newer, safer pharmacological options for depression (e.g., tricyclic antidepressants and MAOIs) and better understanding of safer weight management strategies. As a result, Dexamyl was discontinued by SKF, and its era as a mainstream psychiatric drug came to an end.
Historical vs. modern treatment comparisons
| Feature | Dexamyl (Discontinued) | Modern Treatments (e.g., SSRIs, ADHD meds) |
|---|---|---|
| Composition | Combination of stimulant (dextroamphetamine) and sedative (amobarbital). | Targeted, often single-compound drugs (e.g., sertraline for depression, methylphenidate for ADHD). |
| Mechanism | Stimulates and sedates the CNS simultaneously, with broad, non-specific effects on monoamines. | More specific and refined mechanisms, targeting particular neurotransmitter systems (e.g., SSRIs target serotonin). |
| Risk of Abuse/Dependence | Very high due to the presence of both an addictive stimulant and a habit-forming barbiturate. | Significantly lower for most modern antidepressants. Stimulant medications for ADHD still carry abuse potential but are better understood and regulated. |
| Side Effects | Diverse and often severe, including cardiovascular issues, insomnia, psychological disturbances, and potential overdose risk. | Better-tolerated side effect profiles, although still present. Cardiovascular risks are still a concern with stimulant use. |
| Regulation | Loosely regulated initially, leading to widespread abuse before being tightly restricted and ultimately banned. | Highly regulated as Schedule II controlled substances (e.g., dextroamphetamine), with strict prescribing protocols. |
The legacy of Dexamyl
The story of Dexamyl serves as a powerful historical lesson in pharmacology. It illustrates the transition from broad-spectrum, often haphazard drug combinations to more targeted, safer therapies based on a deeper understanding of neurochemistry. While Dexamyl represented a certain innovation in balancing opposing drug effects, its heavy baggage of dependence and abuse ultimately sealed its fate. The discontinuation of Dexamyl paved the way for more rigorous drug development and regulation, leading to the sophisticated medications available today.
Conclusion
Dexamyl was prescribed primarily for depression, obesity, and anxiety in the mid-20th century. Its formulation combined a stimulant and a sedative, a seemingly innovative approach at the time to elevate mood and curb appetite while mitigating side effects. However, the high potential for abuse, severe side effects, and the development of more effective and safer treatment alternatives led to its discontinuation. The medication's legacy underscores the importance of ongoing research and stringent regulation in the pharmaceutical industry to ensure patient safety. The comparison with modern treatments highlights how far psychopharmacology has advanced since the Dexamyl era. For more context on historical pharmacological trends, you can explore academic resources on psychostimulant history.
