BOOK REVIEWED-Intoxicating Minds
by Ciaran Regan
Weidenfeld & Nicolson: 2001. 164 pp. £14.99
AP
Whether we approve or disapprove, mind-altering drugs are central to the human experience.
At first sight, Ciaran Regan seems to have attempted the impossible — a summary of the whole of psychopharmacology in less than 50,000 words aimed at a general readership. But he has been remarkably successful and has written an entertaining and informative account of mind-altering drugs, with a minimum of technical jargon or chemical structures.
The book covers essentially all of the drugs that are used recreationally — both the legal ones (caffeine, nicotine and alcohol) and the illegal ones (amphetamines, ecstasy, cocaine, cannabis, heroin and the hallucinogens). For all of these he manages to convey up-to-date information about how they work, at the same time giving the reader basic information about the brain and neurotransmitter mechanisms involved. The book gives a very good basic overview of brain function, including a digression into the mechanisms involved in memory.
The author takes a non-judgemental approach to his subject matter. As he puts it: "What is needed is an excavation of the drug myth. This [book] does not extol or condemn drug use; it simply invites reflection." This refusal to demonize drug-taking is refreshing.
Another large section of the book describes the drugs used to treat mental disorders — the anti-anxiety agents, antidepressants, antipsychotics and lithium. There are accurate and insightful descriptions of the illnesses themselves, with plenty of up-to-date information. The discussion of antidepressants, for example, accurately points out the irony that the pharmaceutical industry has now come full circle. The early antidepressant drugs imipramine and amitriptyline inhibited the reuptake by neurons of the two neurotransmitters noradrenaline and serotonin. The Prozac generation of serotonin-selective reuptake inhibitors replaced these. But the latest antidepressants are again combined noradrenaline- and serotonin-reuptake inhibitors — albeit with fewer side effects than imipramine and amitriptyline. Similarly, in the development of new drugs to treat schizophrenia there has been little success in breaking away from dopamine-receptor blockade as the universal mechanism of action.
The author writes in a lively and engaging style, and the text is full of anecdotes about how drugs were discovered or how their use originated, in many cases early in human history. I could find little to criticize in terms of the scientific accuracy of any part of the book, although the description of significant alcohol abuse as requiring the consumption of "at least a bottle of whisky a day for a period of several weeks" did seem to smack a little of Irish hyperbole!
Professional neuroscientists and pharmacologists will find little here that they do not already know — although they may find many of the historical anecdotes interesting and amusing. Did you know, for example, that the first antidepressant drug, the hydrazine derivative iproniazid, originated in part because Germany was left with a large stock of unused hydrazine rocket fuel at the end of the Second World War? The book can certainly be recommended to non-experts who want to know more about mind-altering drugs.
