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The effects at first were not marked: it works more slowly than chlorpromazine. But the effect is cumulative. Within a day or two, the women were calmer and quieter. Soon they began to eat better, and gained up to ten pounds in two weeks. Many who had been hostile to the attendants, or had mutely avoided them, sought them out and wanted to talk. They reported vivid but not unpleasant dreams.
At the end of ten weeks, the first patient was ready for discharge. A petite blonde, 36, wife of a journeyman carpenter, she had been in and out of state hospitals throughout the Midwest for ten years. In her hallucinations she heard voices: her dead mother calling "Come to me," her own daughter calling "Mummy," and finally a man telling her that her husband was unfaithful and she should leave him. She had left him many times, only to wind up in hospitals, where electric shock made her outwardly calmer but with no normal ebb and flow of emotional responses. After reserpine, and with no more help from the psychiatrists than she had always had, the woman went home on a maintenance dose of one reserpine pill a day. Her husband had only one complaint: she had become so demanding in her new-found love for him he wondered whether the doctors could make her pills a bit smaller.
Of the 82 patients in this group, 59 have been discharged or will be as soon as a home can be found for them; twelve have shown varying degrees of improvement, and only eleven are unchanged. In a more severe test on 104 women and 35 men who had had electric shock without benefit, Dr. Tasher has reported on only two months of treatment. But already 19 are home or ready to go (one man had been at Manteno for 13 years); 52 others have improved.
Otter Uses. By no means all the thousands of patients at a hospital like Manteno are fit to live in the wards. At any one time, hundreds are hospitalized with every disease in the book. Their plight had long been a nightmare to Dr. William J. Gallagher. Chlorpromazine to him has seemed like the answer to a prayer. Agitated patients who previously could not be kept quiet without undesirably heavy doses of barbiturates now rest comfortably. And, more important, they stop resisting the medical or surgical treatment that they need. After operations, they allow surgical wounds to heal.
Both chlorpromazine and reserpine have a wide variety of other uses. They quell much of the agitation and bickering of senile patients. General paresis (the result of long-standing syphilitic infection) has yielded spectacularly to treatment with reserpine. One patient at the District of Columbia's mammoth St. Elizabeths Hospital has provided a wry quantitative measure of the drug's effect. He had suffered for years from the hallucination that each night 1,000 women visited his room. After the calming effect of reserpine he is still hallucinated—but 99.9% improved: now he has visions of only one woman each night.
Equally striking is the effect of chlorpromazine on delirium tremens. Patients do not develop the usual panic, nausea and chills; tremor subsides so quickly that they can be discharged after half the usual time, or less.