The societal embedding of new (medical) technologies involves not only market success, but also regulation and public acceptance. Cultural enthusiasm about their benefits and social concerns about their risks and dangers are in this respect important. Conceptualizing interactions between product championing, cultural enthusiasm and resistance, the article analyses three patterns of societal embedding: (1) hype-cycle, (2) contested embedding, and (3) controversy and stalemate. A fourth pattern of waves of enthusiasm and concern is proposed for technologies with unexpected side effects. This pattern is explored and elaborated with a longitudinal case study of the introduction of a particular form of medical technology: psychotropic drugs such as Veronal and Valium in the period 1900-2000.

This article compares the careers of two families of 20th-century psychotropic drugs, the barbiturates and the benzodiazepines, in five different countries. Both families of drugs were used as so-called hypnotics and sedatives, and later as minor tranquillizers. In addition these drugs were extensively used as self-medication. The careers show a cyclical temporal course and generally encompass three phases: first, an expanding use of the drugs, accompanied by high expectations; then, rising criticism and disappointment; and finally contracting use and limited application. These phases need not have been sequential: they often overlapped. The cycle sometimes ended by the disappearance of the drug from mental health care, only to be replaced by new drugs with a profile of promise and hope. These cycles, which we term Seige cycles, are generally typical for the careers of psychotropic drugs. The analytical concept of the Seige cycle facilitates a comparative perspective on the commonalities as well as the differences between the various drug careers under consideration.

This article compares the careers of two psychotropic drugs in Western psychiatry, with a focus on the nineteenth century: Cannabis indica and chloral hydrate. They were used by doctors for similar indications, such as mania, delirium tremens, and what we would now call drug dependence. The two show similar career paths consisting of three phases: initial enthusiasm and therapeutic optimism; subsequent negative appraisal; and finally, limited use. These cycles, which we term "Seige cycles," are generally typical of the careers of psychotropic drugs in modern medicine. However, differences in the careers of both drugs are also established. The phases of chloral show relatively higher peaks and lower valleys than those of cannabis. Chloral is the first typically "modern" psychotropic drug; a synthetic, it was introduced in 1869 at a time of growing asylum populations, pharmaceutical interests, and high cultural expectations of scientific medicine. Cannabis indica, introduced in the 1840s, is typically a "premodern" drug steeped in the climate of cultural Romanticism. We conclude that the analytical concept of the Seige cycle is a useful tool for future research into drug careers in medicine.

The making and taking of psychotropic drugs, whether on medical prescription or as selfmedication, whether marketed by pharmaceutical companies or clamoured for by an anxious population, has been an integral part of the twentieth century. In this modern era of speed, uncertainty, pleasure and anguish the boundaries between healing and enhancing the mind by chemical means have been redefined. Long before Prozac would become a household name for an 'emotional aspirin' did consumers embrace the idea and practice of taking psychotropics not only to treat mental illness but also to make them feel better about living in a modern world. The Freudian promise that each individual can remake him-or herself in the pursuit of health and happiness was helpful in promoting and legitimizing the idea and practice of seeking wellness on prescription. We will argue that the modern consumer-driven political culture of medicine will continue to transverse the boundaries of therapy and enhancement of the mind into the largely unexplored territories of human cognition and behaviour. However exciting, this endeavour will come at the cost of further widening the problem of iatrogenic addiction in the age of happiness pills as 'botox' for the mind.

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