Maude's Mania

Television's Maude is an erratic woman, occasionally daffy, but is she a manic-depressive? And in this week's episode, does she actually take lithium carbonate, hailed by one specialist as "the first wonder drug of psychiatry"? Only her doctor knows for sure. Her scriptwriters don't, because they fudged the symptoms of manic-depression and substituted "proper medication" for "lithium"--all because Maude's illness was likely to create a stir in real-life medical circles.

Lithium, a natural alkali salt of the same family as sodium and potassium, is an accepted drug, but exactly who should be taking it remains in doubt. The Food and Drug Administration has approved the drug for use only during the manic phase of manic-depression--a violent swing of moods from mind-racing euphoria to utter despair. Some doctors feel that lithium is being touted so hard that programs such as Maude may cause a public clamor for lithium to combat both severe depression and simple cases of the blues. Says Dr. Samuel Gershon of New York University's Medical School, who has done extensive research with the drug: "Manic-depression is what it should be used for, and that's not a common disease."

Norman Lear, creator-producer of the Maude series, developed the simplistic two-part story because a member of his family took lithium for manic-depression "and I have personally seen the results." Lear had the scripts checked by Harvard's Dr. Marcia Guttentag and by the director of research at Rockland State Hospital, Dr. Nathan S. Kline, a lithium enthusiast who has treated some 2,000 patients with the drug. Kline's book on depression, From Sad to Glad, was plugged on the Maude show.

Before Maude, the most prominent lithium patient was Director-Producer Joshua Logan. In 1973 Logan revealed that his 30-year struggle with manic-depression had been successfully ended by lithium after psychoanalysis and antidepressant drugs failed. Since then, lithium has become "in." Dr. Ronald Fieve of the New York State Psychiatric Institute, who treated Logan, trumpets lithium in his book Moodswing (William Morrow and Co.) as the start of a revolution in psychiatry in which drug cures will supersede psychoanalysis and other therapies aimed at emotional change. To the dismay of many Freudians, Fieve said that Freud's classic analysis of the "Wolf Man" was a failure, and that the patient, a severely disturbed Russian aristocrat, could have been cured quickly with lithium.

Blitz Alert. Some 50,000 to 100,000 Americans are now on lithium, and Fieve thinks "millions more" could benefit from it. Critics complain that the drug is already reaching patients who are not manic-depressives. Fieve thinks wider use is bound to come. His own four-year study reports lithium is "clearly effective" for severe recurrent depression. The drug is now being tested for everything from schizophrenia to alcoholism and aggressive behavior. The drug is nonaddictive but must be carefully monitored, and blood levels should be checked frequently; an overdose can bring on coma or death. Cautions Dr. Ralph R. Greenson, a Beverly Hills psychoanalyst: "It is a marvelous drug, but also a dangerous drug."

Though Maude's doctored scripts may not promote lithium use, Dr. Guttentag thinks that the two shows may promote better mental health. She alerted all the more than 200 CBS affiliates to be ready for a post-Maude blitz of phone calls. Thirty-five affiliates agreed to run public service spots telling viewers where they can get help. Most of the rest of the stations stood ready to refer troubled callers to state or local mental health centers. More dubious is Dr. Fieve, who wishes that the subject had been treated on a better program.

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