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Results with Chlorpromazine. Injections of chlorpromazine worked wonders. Men and women who had been continuously manic for a year or more quieted down, were soon content to lie down on their beds, and seemed to spend much of the time sleeping. But this was no drugged, disordered sleep such as follows heavy dosing with barbiturates, scopolamine or insulin. A gentle shake of the shoulder would bring the patient wide awake at once, able to give sense-making answers. After a few days the somnolence wore off, but the patients remained calm. They willingly took pills instead of requiring injections, fed themselves, ate heartily and slept well. Not all patients responded equally well. But among 77 manics, Dr. Lehmann saw no total failures; 27 were somewhat improved, nine improved enough to go home despite some lingering illness, and 37 went home "recovered." In four cases, incipient attacks of mania were averted.
Early success with this type of case prompted the Montreal doctors to try chlorpromazine on schizophrenia victims. Some types of schizophrenia are marked by extreme excitement and by persecution delusions. It was in these types that Dr. Lehmann found chlorpromazine most effective; most patients calmed down dramatically, and many lost so much of their fear and anxiety that they could easily talk about their troubles. Again patients' responses varied widely; the longer the illness had lasted, the less likely was it that the patient would recover enough to go home. In the U.S., 300,000 schizophrenics fill about half the mental hospital beds, and after a stay of two years or so, their chances of being discharged have been slim indeed. The new drugs have already begun to change this.
Results with Reserpine. One of the biggest mental institutions in the U.S. is Illinois' Manteno State Hospital, 45 miles south of Chicago. Rated for 5,000 patients, it holds 8,200. Its physical plant, dating from the 1930s, is reasonably modern. In its overcrowded red brick buildings, Psychiatrist Dean C. Tasher had seen hundreds of patients drift downhill to the "very disturbed" wards where they persisted in lying naked on the floor in their own filth, and some eventually to the hydrotherapy ward, where they had to be kept in tubs or wet packs for most of the day.
When he got reserpine last summer, Dr. Tasher made his test as rigorous as possible. He chose patients in whom all the approved treatments—and others now discarded—had failed to bring lasting improvement. They had got as much psychotherapy as the short staff could provide—all to no avail.
Of the 221 patients first chosen, 82 were women who responded temporarily to electric shock. They had to have it once or twice a week to remain in partial contact with reality; otherwise they were certain to relapse into a far more serious state, and none could go home for more than a weekend. They had been at Manteno from one to six years. Dr. Tasher cut out the electric-shock treatments and let reserpine take over.