Insomnia and death of marilyn monroe

Abstract

Introduction Marilyn Monroe (MM) was an American actress who died from an overdose of sleeping drugs in 1962. This presentation reviews the history and management of the insomnia she suffered. Materials and methods Source materials include police and toxicology reports on her death, prescriptions for sleeping drugs filled in the last few months of her life, photographs of her home, filmed or direct accounts from verified witnesses, and Donald Spoto’s 1993 biography. Results MM valued nocturnal sleep to help her look good at work, but developed insomnia during her rise to fame in the context of stage fright. She might have presented jet lag following a flight from Japan, and started using barbiturates due to their easy availability. She became interested in psychoanalysis as a way of self-knowledge and acting improvement. Her psychiatrists treated her with Freudian psychoanalysis and an intensive use of drugs. Her last psychiatrist mostly dealt with psychoanalysis and had a general practitioner to prescribe her drugs. During the last few months of MM’s life she was prescribed a dozen different psychoactive drugs, mostly barbiturates, but also other hypnotic drugs and amphetamines. The major issues regarding her death include the time of death, the position of the body and the sincerity of the witnesses. Blood/ liver samples tested for pentobarbital and chloral hydrate showed lethal concentrations of both. Disturbingly enough, her doctor claimed he only prescribed pentobarbital and never chloral hydrate, which is not true. Drugs complicated the course of MM’s insomnia and had a negative effect on her general health and behaviour, a situation seemingly ignored by the two different psychiatric diagnoses given to her by both doctors (“addictive paranoid borderline personality”, and “manic-depressive or bipolar personality”). Barbiturates had been available for several decades at the time, and the issues of tolerance, dependency and accidental overdose had to be well known to them. On the other hand, MM thought she exercised a reasonable control on her drug intake, which along with a lack of a real medical control and the presence of spurious interests set the conditions for the advent of a grim outcome. Conclusion The treatment based on Freudian psychoanalysis and drugs failed to improve MM’s condition and arguably worsened it. The very drugs prescribed to her to combat insomnia would eventually cause her death.