Major and Minor Tranquilizers - The Life of a Hotel Doctor

Guests often ask for something to calm them, and I try to comply by stocking Valium.
Tranquilizers relieve generalized anxiety but not the pain of a terrible event such as a family
death. Unhappy guests regularly ask for something to "put me to sleep," but only general
anesthesia does that. Even sleeping pills merely produce drowsiness; if you're miserable,
sleep comes hard.

I give a Valium injection if asked, but I have a low opinion of its tranquilizing properties.
Valium pills work better because the more you take, the drowsier you get. The effect of the
maximum Valium injection does not impress me. Thorazine works better.

Valium and its relatives are minor tranquilizers; the Thorazine family belongs to the major
tranquilizers. "Major" and "minor" have nothing to do with strength; they refer to the
seriousness of the disease. Thorazine helps schizophrenia, a major mental illness. The first of
a numerous class of drugs called phenothiazines, its discovery in 1952 marked a huge
advance because it calmed schizophrenics enough so that most could leave mental hospitals
and live on the street, thus saving tax money.

People who deny that schizophrenia is a brain disease claim Thorazine works because it
makes patients somnolent. In fact, many newer phenothiazines aren't sedating, but they
work as well. Thorazine and its family turn off the positive symptoms of schizophrenia:
hallucinations, delusions, bizarre behavior. Movie schizophrenics seem to enjoy themselves,
but hearing a voice inside their head frightens most people even if it's God.

Despite their dramatic effects, phenothiazines don't cure schizophrenia because they don't
eliminate the negative symptoms such as apathy, social withdrawal, and self-neglect. Being
around a well-behaved schizophrenic remains an uncomfortable experience. Something is missing.