Books are no longer read but eaten, not made of paper but some informational substance . . . . I also did a little browsing in a psychem supermarket. Self service. Arranged on the shelves are beautifully packaged opinionates, gullibloons -- credibility beans? -- abstract extract . . . and iffies, argumunchies, puritands and dysectasy chips.
Stanislaw Lem in "Futurological Congress"
Drug companies have started a high-stakes competition to come up with the first in a new class of mind drugs, the so-called "cognitive" ones that will boost human learning, attention and memory.
At least half a dozen companies are now pouring money and time into the search for an "intelligence boosting" drug.
"There is an enormous amount of activity in this area now," said Herbert Weingartner of the National Institute of Mental Health, who has carried out some of the tests of cognitive drugs on humans. "All the drug companies you can think of are very active. Warner-Lambert, Hoffmann-LaRoche, Ciba-Geigy, Sandoz, Lederle." For a decade there have been tantalizing hints that man might be able to grasp at least a corner of the centuries-old dream of increasing intelligence and revitalizing the mind. One substance, vasopressin, tripled the length of mouse memory. In humans a similar substance, dubbed DDAVP, caused improvements from a few percent to 20 percent on various tests of learning and memory. Another substance called MSH has also apparently increased cognitive power, chiefly by boosting alertness or attention.
And there are more: The brain science revolution of the past 10 years has plumbed the depths of brain chemistry, and come up with a dozen or more brain chemicals that appear to have some small but distinct and repeatable effect on human thinking power. All have their drawbacks. Some are too toxic to use on humans. Some break down in the body too fast, and so on. None will be made into drugs soon.
But the first signs are there. The locked box of human learning and memory systems has opened enough so researchers and even dollar-conscious drug companies feel they cannot be too far from what they finally seek.
The cognitive drugs are but one example of the cornucopia of brain chemicals found by brain researchers recently, some with tantalizingly powerful effects on the the mood and behavior of animals. If what goes on in animal brains were any guide, we would be on the verge of a drug wonderland.
In mice and rats and monkeys, scientists have been able to boost memory or induce forgetfulness, recharge a lagging sex drive, bring on anxiety or return it into placidity, induce sleep, trigger dreaming, increase or decrease thirst or appetite.
One promising substance in the battle against obesity is called CCK (cholecystokinin). When animals (the experiment has been done in many species from rats to sheep to monkeys) and humans fast overnight, then are presented with food in the morning, those who get an injection of CCK find themselves far less interested in food, according to Jacqueline Crawley, neurobiologist at E.I. DuPont de Nemours, who is studying the substance and how it controls appetite.
Those given CCK eat about a quarter of the amount eaten by those who do not get the chemical. Side effects of the drug have not been reported, but it is possible that one may be a decline in attention and learning ability. "My idea is that satiety is a broad underlying state which creates less interest not only in food but in many other things in the environment as well," Crawley said.
Another chemical, which some think may be a step toward the mythological aphrodisiac drug, has been shown to have a strong effect on the sex systems of both man and animal. It triggers an elaborate mating ritual in mice, and keeps them occupied with sex far above normal levels.
In humans, the drug has been used experimentally to help restore the potency of impotent men. Researchers say there is no question that it has a powerful effect on the libido of animals, and in man the question is still wide open.
These brain substances have created some excitement because they seem to be substances which affect the body's systems for anxiety, appetite, sex, sleep, memory and so on. It is the first time that man has begun to tap directly into these systems, in some cases using the brain's chemicals for these activities.
It will be years before it is known if any can be exploited, but the first with an effective cognitive drug or with a diet or sex drug, for that matter, will win a lucrative prize in sales. "You have no idea," said Leonard Cook of Hoffmann-LaRoche.
Valium, for example, the last great hit among the mind drugs, accounts for 40 percent of Hoffmann-LaRoche's $1.4 billion yearly income.
A cognitive drug might be even bigger. The interest in it is universal. "We certainly have no problems in getting volunteers. Every time you walk from one end of the house to the other and forget what you went for, it makes you think about this," Cook said.
But taking mind-shaping drugs from the lab to the drugstore involves far more questions than how to package them.
Says Frederick Goodwin, director of research at NIMH's labs, "That is part of the reason the brain sciences fascinate; we are dealing with the things about man that have been most uniquely human, even spiritual." How such drugs change people, what bad effects are traded for good ones and how society will accept these changes are issues that must be raised as the drugs move from the lab into homes.
For instance, Goodwin asks, is enhanced memory a good thing?
He notes that in severely depressed patients, too sharp a memory can be a problem. Far too vivid and emotional memories are carried on long past their usefulness and brought up again and again almost obsessively.
A rat will remember a blue light and a shock for a couple of days. But with a memory drug it will fear the light and shock for 10 days or more. Ceasing normal exploratory behavior out of fear, it will have trouble finding food.
"Can we enhance memory? Yes," Goodwin says. "But what does it mean to enhance normal memory? Does it mean we become smarter, or just that we become more stuck on memories?"
Part of the power of the new brain chemicals is that they act on specific parts of the mind to trigger specific behavior, rather than causing the kinds of gross action familiar with mind drugs such as alcohol, methaqualone or heroin.
This new power of the brain sciences has caught the notice of many newspaper and magazine writers. They have trumpeted the coming of a "choose-your-mood" society. Said one prominent business magazine: "chemical behavior modification" of the populace "is not all that far from becoming reality."
For decades novelists have warned about the chemically engineered personality, from the drug called Soma of Aldous Huxley's "Brave New World" to the spectacular listing of future pharmacology in Stanislaw Lem's "Futurological Congress."
Lem fantasizes on the items stocking the shelves: "Benignizers," such as Hedonidol, Euphoril, Inebrium, Felicitine, Ecstasine, alongside their antagonists, Juggernol, Furiol, Dementium, Flagellan. Vigilax to make you alert and retentive. Amnesol to relieve you of burdening memories. But researchers now have found drugs that have at least a semblance of these properties, including an alertness drug, a substance that induces forgetfulness, calming drugs and their opposites which create fear and anger.
For each possible mind drug, both uses and abuses can be imagined. Might not the so-called "anti-Valiums," which create anxiety, fear and aggression, be used in some punishment, perhaps as a simpler and more direct form of the fright therapy given to more than 150 inmates in two California prisons a decade ago?
In that case, inmates were given the treatment for antisocial behavior. Each man was strapped to a table and injected with a drug that first caused paralysis of his limbs. Then his chest went numb and his head drooped uncontrollably. Finally, for about two minutes, he could not work the muscles that suck air and could not breathe. The horror of suffocation gripped his mind. At this moment, the doctor sternly instructed the inmate to stop his antisocial behavior or else.
"You know, when you can't breathe you are quite receptive to what other people are telling you," Dr. Martin Reimringer, who administered the drug at Atascadero State Hospital, said.
The possibility that the drugs coming from the brain researchers' laboratories will be used in such fashion causes horror in some.
But doctors and researchers generally are trying to act to alleviate human suffering, and drugs have done much of that over the years. Current drugs become safer with research and less susceptible to abuse, and new drugs sometimes create more effective treatment of disorders.
Two drugs now in human clinical trials are intended to supplant the tranquilizers of recent decades -- Valium, Librium and the rest of that chemical family -- with more specific and safer compounds.
Though Valium and the others relieve anxiety, they also have strong sedative properties that make it somewhat dangerous for users to drive, and very dangerous to drink. They also relax the muscles and give enough feeling of euphoria to make them popular for illegal sale as recreational drugs. And they create dependency in thousands.
In the hope of remedying those defects, Mead Johnson has come up with Buspirone and Lederle with TPZ. Trials indicate the new drugs do not have the strongly sedating side effects, do not impair driving and are safely taken with alcohol. Nor do they have the sought-after "buzz" of Valium.
One of the drugs has even been put through an unusual research test at Maclean Hospital in Boston. Psychiatrist Jonathan Cole has a group which compares, rates and details effects of recreational drugs.
The brain sciences revolution brings more closely into focus a view of man that has been emerging for a century, that his behavior is under self-control, but that his conscious self presides only loosely over the speeding electricity and flowing chemistry that carries on life within.
NIMH's Goodwin puts it this way: "That these myriad of subtle problems which had been thought of as caused by anything from bad conscience, to sin and guilt, to how your parents toilet-trained you, we are now saying, hey, not only are the major devastating illnesses strongly influenced by your biology, but even some of the subtler things, the supposed personality problems, are also heavily influenced by biology . . . and can be affected by drugs."
Psychiatrists have dwelled on the subtlety and complexity of human emotion, of anxiety, of depression. Now they marvel how a minute amount of a chemical substance can use the neurotransmitter system to alter behavior in a refined, specific manner.
Speaking of severely depressed patients, psychiatrist Philip Gold at NIMH said he found it curious that when these patients respond to medication, "they don't feel like a different person. They don't think about life differently." Ten days after taking an anti-depressant drug, for example, a patient's guilt simply begins to dissipate.
"The guilt is diminished a great deal without a lot of learning about how to cope with guilt," Gold says. "At least, the horrible negative charge of guilt has been ameliorated. Some learning still needs to take place in how to cope with these feelings, or these people may be vulnerable again."
But drugs exert an extraordinary direct effect. "There is some emotional tone control in the brain that really sort of sets these moods," Gold says. And drugs can set the tone.
But mental illness, like heart disease, is still not believed to have an exclusively biological cause. Psychiatry will not be out of business soon.
Gold recalled that during his years of training as a doctor and a psychiatrist, there were fierce fights between those who believed the answer to human suffering was all biology and those who believed it was all psychology.
But now in practice, he sees the value of both.
"I think it's important for psychiatrists to acknowledge that it's not all biology or all experience. We must have some humility about this, to say that we don't really understand either, and that we should minister to human misery using what we understand of each."
Fred Goodwin added that the new biological understanding of disease "has actually liberated psychoanalysis and psychotherapy. Now psychotherapy can address the thing which it can do well. For example, how does the patient deal with the loss of self-esteem which comes as the scars from mental illness? How does one put together a decent interpersonal life after illness and a series of marriages that have broken up as a result?
"Before these medications, all these things were defeated by the fundamental illness. You cannot work effectively with a profoundly depressed patient, or with a manic patient. Psychotherapy has had removed from its purview the necessity to prove itself with the worst cases. It is now freed to work in the arena where it can be helpful."