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HOW VALIUM HELD THE TOP PRESCRIPTION SPOT FOR THIRTEEN YEARS
Before Benzos, There Was A Different Drug
It Also Worked
It Also Killed People
Easily
A Chemist In Switzerland In 1954 Was Trying To Solve An Entirely Different Problem
He Nearly Threw The Answer Away
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OKAY BACK FROM THE LAB 🧪
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THE DRUG THAT CAME BEFORE 💀
Before Benzodiazepines Existed
The Standard Treatment For Anxiety And Insomnia Was Barbiturates
Phenobarbital
Seconal
Nembutal
They Worked On The Same GABA System
They Were Effective
They Were Also Extremely Easy To Overdose On
The Difference Between A Therapeutic Dose And A Fatal Dose Was Narrow
Marilyn Monroe
Judy Garland
Alan Turing
Barbiturate Overdose Was Not Rare
It Was A Known Risk That Doctors Accepted Because There Was No Better Option
The Medical World Needed Something That Calmed The Nervous System Without The Margin For Error Being That Thin
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THE ACCIDENT 🔬
In 1954, A Chemist Named Leo Sternbach Was Working At Hoffman La Roche In Basel, Switzerland
He Had Been Tasked With Finding A Safer Alternative To Barbiturates
He Had Synthesized A Series Of Compounds And Tested Them
None Showed Promise
The Project Was Deprioritized
In 1957, While Cleaning Out His Lab To Begin A New Project
Sternbach's Assistant Found One Untested Compound Still On The Shelf
Sternbach, Almost As An Afterthought
Sent It To Pharmacology For Testing
The Results Were Remarkable
The Compound Produced Sedation
Muscle Relaxation, And Anti Anxiety Effects In Animals
At Doses That Were Not Toxic
The Drug That Would Become Librium Had Been Sitting On A Shelf For
Three Years Waiting To Be Thrown Away
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FROM LIBRIUM TO VALIUM 💊
Chlordiazepoxide, Branded As Librium
Was Approved By The FDA In 1960
It Was The First Benzodiazepine To Reach The Market
Three Years Later, Sternbach Developed A Refinement
Diazepam
Branded As Valium
It Was More Potent, Faster Acting, And Cleaner In Its Effect Profile
Hoffman La Roche Launched It In 1963
The Pitch Was Simple And Accurate
Safer Than Barbiturates
Works Better
Has A Much Wider Safety Margin
The Medical Community
Which Had Been Watching Patients Die From Barbiturate Overdose For Decades
Embraced It
MOTHER'S LITTLE HELPER 🎵
By 1969, Valium Was The Most Prescribed Drug In The United States
It Held That Title Until 1982
Thirteen Consecutive Years
In 1966, The Rolling Stones Released A Song Called Mother's Little Helper
The Lyric Was About A Housewife Who Could Not Get Through The Day Without Her Pills
It Was Not A Metaphor
Doctors Were Prescribing Valium To Women At Twice The Rate They Prescribed It To Men
The Diagnosis Was Vague
Nerves. Anxiety. Difficulty Coping.
The Prescription Was Specific
A Bottle Of Small Yellow Pills That Made The Day Manageable
Women Were Not Being Treated For A Disorder
They Were Being Chemically Adjusted To Tolerate Circumstances That Were Making Them Miserable
The Drug Did Not Fix The Problem
It Made The Problem Quieter
THE GRAPEFRUIT NOBODY WARNED YOU ABOUT 🍋
Here Is Something That Is Still Not On Most Prescription Labels
Grapefruit Juice Inhibits The Enzyme That Metabolizes Benzodiazepines In The Body
The Enzyme Is Called CYP3A4
It Breaks Down Benzos In The Liver Before They Reach Full Concentration In The Bloodstream
Grapefruit Blocks That Process
A Standard Dose Taken With Grapefruit Juice Can Result In Blood Levels Two To Three Times Higher Than Intended
A Therapeutic Dose Can Become An Overdose
A Glass Of Juice With Breakfast Is Not Listed As A Drug Interaction Warning On Most Benzo Prescriptions
The Molecule Has A Longer List Of Vulnerabilities Than The Label Admits
