The discovery of chlordiazepoxide and the clinical introduction of benzodiazepines: half a century of anxiolytic drugs.

The clinical introduction of chlordiazepoxide half a century ago was one of the major breakthroughs in the history of psychopharmacology, as it opened the door for the benzodiazepine saga, the pharmacological family par excellence in the treatment of anxiety disorders. This review analyses the discovery of this drug, which was filled with chance events, and numerous chemical and clinical errors of approach. Chlordiazepoxide, initially called methaminodiazepoxide, was patented in 1958 and introduced in clinical treatment in 1960 under the brand name Librium®. The benzodiazepines became the most widely prescribed drugs worldwide, provided truly effective treatment for "minor forms" (neuroses) of mental disorders for the first time, increased the quality of scientific methodology in clinical research, and enabled the development of new etiopathogenic theories for anxiety disorders, especially after the discovery in 1977 of their high-affinity receptor complex.

Social reactions to Valium and Prozac: a cultural lag perspective of drug diffusion and adoption.

BACKGROUND: In the sociological context, the concept of cultural lag holds that material technologies advance more rapidly than social guidelines for their use. The result can be social conflict including liability accusations and product stigmatization that have characterized several new drugs which were widely accepted initially but then publicly criticized in the lay and scientific press. OBJECTIVES: The objective was to illustrate the utility of the concept of cultural lag to technology commercialization by applying cultural lag to the social and professional environments surrounding the diffusion of the "minor tranquilizers" Librium and Valium in the United States from the 1950s to the 1970s, and the antidepressant Prozac from 1987 to 2005. The intention is to develop a perspective from which to view patterns of social acceptance followed by critique that may occur when technological advances are introduced to the marketplace. METHODS: This study systematically reviews academic, medical, and lay literature regarding the diffusion of the "minor tranquilizers" Librium and Valium in the United States from the 1950s to the 1970s, and the antidepressant Prozac from 1987 to 2005. RESULTS: The minor tranquilizers and Prozac both reveal similar patterns of initial widespread public endorsement, followed by growing public criticism and recommendations for more restrictive usage guidelines. CONCLUSIONS: Cultural lag provides a perspective from which to anticipate, view, and avoid controversies that develop from new technologies in general and pharmaceutical technologies in particular. Market demands for rapid introduction must be balanced by public education. This requires proactive encouragement of lay and professional discussions and the establishment of marketing guidelines that aid development of social consensus regarding appropriate usage.