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Effectiveness Of Insulin Shock Therapy

The History Of Shock Therapy In Psychiatry

The History Of Shock Therapy In Psychiatry

Renato M.E. Sabbatini, PhD Fever and Mental Disease The Insulin Shock Therapy Chemical Convulsions and Schizophrenia The Electroconvulsive Shock Therapy The early decades of the 20th century witnessed a major revolution in the understanding and treatment of mental diseases. Until then, people with psychoses were usually locked away in insane asylums, receiving only limited custodial care and sometimes social support, with practically no effective therapeutic options left to the alienist, as psychiatrists were called then. Although well-intentioned medical reformers such as Phillipe Pinel eased the nightmarish conditions of insane asylums in force well into the first half of the 19th century, no treatments were generally performed. The first revolution was put in motion by scientific psychotherapy, based on theories of the mind proposed by Austrian physician Sigmund Freud, the founder of psychoanalysis. Its value was mainly observable in mild mental disturbances, particularly neuroses. But beginning in the 1930s these methods began to be supplemented by physical approaches using drugs, electroconvulsive therapy, and surgery. The knowledge that head trauma, convulsions and high fever could be good for improving mental disturbances is not new in Medicine. Hippocrates was the first to note that malaria-induced convulsions in insane patients was able to cure them. In the Middle Ages, some physicians observed the same phenomenon after a severe bout of fever; such as after cholera epidemics in insane asylums. In 1786, a physician named Roess claimed improvement in mental patients after inocculation with smallpox vaccine. Furthermore, many physicans along the centuries have noted that there are very few epileptics who are also schizophrenic, and a biological theory on the incom Continue reading >>

Things That Have Given Psychiatry A Bad Name #2 Insulin Coma Therapy

Things That Have Given Psychiatry A Bad Name #2 Insulin Coma Therapy

Insulin is a hormone produced in the body by the pancreas; its main role is to cause cells to take up glucose from the blood thus regulating its level. The history of the discovery of insulin is an interesting one, albeit involving the death of a pack dogs. In 1889, the physicians Oscar Minowski and Joseph von Mering removed the pancreas from a dog to test its assumed role in digestion. Several days after the dog’s pancreas was removed, it was noticed that there was a swarm of flies feeding on the dog’s urine. On testing the urine they found that there was an unusually high sugar content, establishing for the first time a relationship between the pancreas and diabetes mellitus. In 1901, it was established that the diabetes was caused by the destruction of a part of the pancreas called the Islets of Langerhans. These islets had been identified by Paul Langerhans whilst a medical student in 1869. We now know that what the islets were producing was insulin, but this proved difficult to isolate. Nicolae Paulescu a professor of physiology in Bucharest was the first one to succeed and published his work in 1921. Use of his techniques was patented in Romania , but no clinical use resulted. At almost the same time, Canadian Frederick Banting hypothesised that the reason for the difficulties was that some of the other products of the pancreas, digestive enzymes, were destroying the islet secretions before they could be extracted. In the summer of 1921 he was supplied with a laboratory, Charles Best, a medical student assistant, and ten more dogs. The idea was to ligate the dog’s pancreatic ducts; the pancreatic secretions would then pool in the pancreas, but the digestive elements would be reabsorbed leaving the islets. It was found that an extract from these islets was ab Continue reading >>

Insulin Shock Therapy

Insulin Shock Therapy

Psychiatrists are the doctors qualified to be able to perform Insulin Shock Therapy. They earn around $144,020 per year. I find it Psychiarty a very interesting. I would consider persue being a Psychiartist because of how intriguing it is. Insulin was discovered in 1922 and was tested on patients that had illnesses with unknown treatments. Dr. Manfred Sakel used insulin on patients with opiate withdrawels to help calm them down. He the was moved to the university of vienna to work on patients with schizophrenia. Sakel tested what effect insulin would have on the patients and reported that the patients would develop a stupor or coma when using large doses, which caused them to lose their psychotic thoughts. Then in the 1940's this form of therapy was being used in hospitals. Insulin Shock Therapy would be performed by Psychiatrist and hasnt been used since the 1970's. Insulin Shock Therapy was important back then because it helped patients with schizophrenia. It may have not been the best way to help rid schizoprhenia but it did help. Since then people have found other treatments for schizoprhenia such as electroconvulsive therapy which is a bit similar to Insulin Shock Therapy. It helped researchers to look for more effective way to treat schizoprhenia. Continue reading >>

Performing A Cure For Schizophrenia: Insulin Coma Therapy On The Wards

Performing A Cure For Schizophrenia: Insulin Coma Therapy On The Wards

Most historians of psychiatry regard insulin coma therapy (ICT) either as an embarrassing stumble on the path to modern biological psychiatry or as one member of a long line of somatic therapies used to treat mental illness in the mid-twentieth century. This article explores the ICT era, roughly 1933-60, as a key moment in the development of American psychiatry. Developed only ten years after insulin had been embraced as a "miracle drug" for the treatment of diabetes, ICT was perceived by psychiatrists as a means of bringing their field closer to mainstream medicine, particularly to neurology. In addition, the story of ICT reveals how a treatment never quite proven on paper was unquestionably efficacious in the local world in which it was performed. An institutionally-based treatment, ICT was administered in a specific area of the mental hospital deemed the insulin unit, a room with its own staff, practices, and attitudes toward mental illness. There, psychiatrists often experienced wondrous recoveries of individual, formerly intractable patients. These intense personal experiences allowed psychiatrists to feel truly efficacious, enabling them to reinvent themselves as medical doctors rather than behavioral and disciplinary supervisors. The confidence they derived from this capacity, along with the operating room-like setting of the insulin unit, the unit's specialized staffing and group bond, and the availability of both risk-assessment tests and a medley of treatments that countered side effects and complications, allowed ICT to be understood as an efficacious treatment for schizophrenia within the local world in which it was administered. Do you want to read the rest of this article? ... Following the introduction of chlorpromazine in the early 1950s, antipsychotic Continue reading >>

The Perplexing History Of Ect In Three Books

The Perplexing History Of Ect In Three Books

The Perplexing History of ECT in Three Books A History of Electroconvulsive Treatment in Mental Illness by Edward Shorter and David Healy. Piscataway, NJ: Rutgers University Press; 2007 Convulsive therapy, with chemically induced seizures, was first demonstrated in 1934 in Europe to relieve psychosisparticularly the catatonic type. Within 4 years, electrical induction (also known as electroconvulsive therapy, or ECT) was shown to be as effective and much easier to use. For the next 2 decades, ECT became the principal treatment for the severely mentally ill, especially the many thousands warehoused in state hospitals. Its use in psychiatric practice allowed many patients to avoid the stigma of hospital admission and remain at home to lead normal lives. Introduced concurrently with insulin coma (1933) and lobotomy (1935), these 3 treatments were conflated in the public and professional psyche. As insulin coma and lobotomy fell into disuse because of their high morbidity and mortality rates, their demise contaminated the appreciation of ECT. Competition from psychotherapies and then from psychotropic drugs led to the widespread abandonment of ECT in the 1960s and 1970s. Since the mid-1980s, doctors have gradually recognized that ECT can effectively relieve life-threatening conditions that would not otherwise be treated. This change in perspective, coupled with improvements in technique and safety, has resurrected its use throughout the world. Three recent books document this perplexing roller-coaster story. In Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness, medical historians Edward Shorter and David Healy offer a verifiable history that is based on archival records and supplemented by interviews with cooperating researchers and clinicians. In S Continue reading >>

Insulin Shock Therapy

Insulin Shock Therapy

Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks.[1] It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia, before falling out of favour and being replaced by neuroleptic drugs in the 1960s.[2] It was one of a number of physical treatments introduced into psychiatry in the first four decades of the 20th century. These included the convulsive therapies (cardiazol/metrazol therapy and electroconvulsive therapy), deep sleep therapy and psychosurgery. Insulin coma therapy and the convulsive therapies are collectively known as the shock therapies. Origins[edit] In 1927 Sakel, who had recently qualified as a doctor in Vienna and was working in a psychiatric clinic in Berlin, began to use low (sub-coma) doses of insulin to treat drug addicts and psychopaths.[3] Having returned to Vienna, he treated schizophrenic patients with larger doses of insulin in order to produce coma and sometimes convulsions.[3] Sakel made public his results in 1933 and his methods were soon taken up by other psychiatrists.[3] Joseph Wortis, after seeing Sakel practice it in 1935, introduced it to the US. British psychiatrists from the Board of Control visited Vienna in 1935 and 1936, and by 1938 31 hospitals in England and Wales had insulin treatment units.[2] In 1936 Sakel moved to New York and promoted the use of insulin coma treatment in US psychiatric hospitals.[3] By the late 1940s the majority of psychiatric hospitals in the US were using insulin coma treatment.[4] Technique[edit] An insulin treatment ward, circa 1951, Roundway Hospital, Devizes, En Continue reading >>

Insulin Shock Therapy

Insulin Shock Therapy

the entire wiki with video and photo galleries find something interesting to watch in seconds Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks. [1] It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia , before falling out of favour and being replaced by neuroleptic drugs in the 1960s. [2] It was one of a number of physical treatments introduced into psychiatry in the first four decades of the 20th century, these included the convulsive therapies ( cardiazol/metrazol therapy and electroconvulsive therapy ), deep sleep therapy and psychosurgery . Insulin coma therapy and the convulsive therapies are collectively known as the shock therapies. In 1927 Sakel, who had recently qualified as a doctor in Vienna and was working in a psychiatric clinic in Berlin , began to use low (sub-coma) doses of insulin to treat drug addicts and psychopaths. [3] Having returned to Vienna, he treated schizophrenic patients with larger doses of insulin in order to produce coma and sometimes convulsions. [3] Sakel made public his results in 1933 and his methods were soon taken up by other psychiatrists. [3] Joseph Wortis , after seeing Sakel practice it in 1935, introduced it to the US. British psychiatrists from the Board of Control visited Vienna in 1935 and 1936, and by 1938 31 hospitals in England and Wales had insulin treatment units; [2] in 1936 Sakel moved to New York and promoted the use of insulin coma treatment in US psychiatric hospitals. [3] By the late 1940s the majority of psychiatric hospitals in the US were using insulin coma treat Continue reading >>

Shock Therapy | Psychiatry | Britannica.com

Shock Therapy | Psychiatry | Britannica.com

Alternative Titles: ECT, electroconvulsive therapy, electroshock therapy Shock therapy, also called Electroshock Therapy, Electroconvulsive Therapy, or Ect, method of treating certain psychiatric disorders through the use of drugs or electric current to induce shock; the therapy derived from the notion (later disproved) that epileptic convulsions and schizophrenic symptoms never occurred together. In 1933 the psychiatrist Manfred Sakel of Vienna presented the first report of his work with insulin shock . Until the discovery of the tranquilizing drugs, variations of insulin-shock therapy (also called insulin-coma therapy) were commonly used in the treatment of schizophrenia and other psychotic conditions. With insulin-shock treatment, the patient is given increasingly large doses of insulin, which reduce the sugar content of the blood and bring on a state of coma. Usually the comatose condition is allowed to persist for about an hour, at which time it is terminated by administering warm salt solution via stomach tube or by intravenous injection of glucose. Insulin shock had its greatest effectiveness with schizophrenic patients whose illness had lasted less than two years (the rate of spontaneous recovery from schizophrenia also is highest in the first two years of the illness). Insulin-shock therapy also had more value in the treatment of paranoid and catatonic schizophrenia than in the hebephrenic types. Electroconvulsive treatment was more successful in alleviating states of severe depression than in treating symptoms of schizophrenia. Psychosurgery, or surgery performed to treat mental illness, was introduced by Portuguese neurologist Antnio Egas Moniz in the 1930s. The procedure Moniz originatedleucotomy, or Electroconvulsive, or electroshock, therapy, introduced i Continue reading >>

History And Uses Of Insulin Shock Therapy

History And Uses Of Insulin Shock Therapy

Introduction Insulin shock therapy involves the use of insulin to induce hypoglycemia in a patient. The primary use of this treatment was to provide relief from the symptoms of schizophrenia, however it was also used in the treatment of anorexia and morphine addiction. This treatment has fallen out of favor in the United States, much like electroshock convulsive therapy (or "ECT). The movie A Beautiful Mind presented a good depiction of the therapy when the mathematician John Nash received insulin shock treatments in an effort to cure his schizophrenia. Other famous patients included: James V. Forrestal (the first US Secretary of Defense, who committed suicide in 1949), Russian ballet dancer Vaslav Nijinsky, and Zelda Fitzgerald (wife of author F. Scott Fitzgerald). The hormone insulin was discovered in 1921. Soon after that insulin was found to be effective in treating anorexia when given in small dosages. Then in 1927 a major breakthrough came when Manfred Sakel, a 27-year-old Polish doctor, discovered that insulin-induced hypoglycemia was effective in the treatment of morphine addicts. Sakel later discovered through an accidental insulin overdose that the treatment was useful in alleviating the symptoms of certain psychosis and in particular schizophrenia. After working on his technique for about 3 years, he officially released reports on his method in late 1933. This was the first known biological treatment for schizophrenia. In 1939 American Psychiatric Association praised "Sakel's Therapy" and another study in 1942 further demonstrated its effectiveness. This praise led to the widespread use of the technique for nearly 30 years. The technique remained largely unchanged for many years, but it gradually came out of favor as more effective techniques were developed. Continue reading >>

Putting Schizophrenia's Demons To Sleep

Putting Schizophrenia's Demons To Sleep

Despite its widespread use, some confusion surrounded the term “insulin coma.” It often has been referred to in the literature as “insulin shock therapy.” The original German term for the treatment (Insulin-shock-behandlung) was translated into English as “insulin shock treatment.”5 Dr. Sakel interposed “shock” to emphasize that lowering blood pressure and accelerating heart and respiration rates “shocked” the body, accounting for the improvement. Later he appreciated that the key aspect was the coma, but the “shock” name stuck, perhaps as a parallel with electroshock therapy. It is easy to see why insulin coma therapy was so well received. Below is how Dr. Sakel described its efficiency: In 1961, John Nash, the subject of the movie A Beautiful Mind, received a six-week course of insulin coma treatment at Trenton State Hospital in New Jersey, with partial remission noted.5 Despite the persistence of insulin coma therapy into the second half of the 20th century, its use began to wane because of several factors, including its dangerousness, lack of permanent results, and the development of chlorpromazine, the first of the truly effective antipsychotic medications. Evidence-based scientific studies do not support the efficacy of insulin coma therapy.8 Insulin coma treatment also was expensive, requiring considerable psychiatric and nursing care.2 As recently as 1992, insulin coma therapy was still in frequent use in Ukraine; 98% of Ukrainian psychiatrists felt that insulin coma therapy was an acceptable and perhaps necessary treatment.9 According to the Ukrainian psychiatrists surveyed, insulin coma therapy had proven to be effective in psychiatric patients in long-term facilities. With improved and instant control of glucose a current possibility, Continue reading >>

Recommended Reading | Ect Justice!

Recommended Reading | Ect Justice!

Before you give true, informed consent for ECT, reference the following: Mechanisms and standards exist to safeguard the health and welfare of the patient, but for electroconvulsive therapy (ECT)used to treat depression and other mental illnessessuch approval methods have failed. Prescribed to thousands over the years, public relations as opposed to medical trials have paved the way for this popular yet dangerous and controversial treatment option. Doctors of Deception is a revealing history of ECT (or shock therapy) in the United States, told here for the first time. Through the examination of court records, medical data, FDA reports, industry claims, her own experience as a patient of shock therapy, and the stories of others, Andre exposes tactics used by the industry to promote ECT as a responsible treatment when all the scientific evidence suggested otherwise. As early as the 1940s, scientific literature began reporting incidences of human and animal brain damage resulting from ECT. Despite practitioner modifications, deleterious effects on memory and cognition persisted. Rather than discontinue use of ECT, the $5-billion-per-year shock industry crafted a public relations campaign to improve ECTs image. During the 1970s and 1980s, psychiatrys PR efforts misled the government, the public, and the media into believing that ECT had made a comeback and was safe. Andre carefully intertwines stories of ECT survivors and activists with legal, ethical, and scientific arguments to address issues of patient rights and psychiatric treatment. Echoing current debates about the use of psychopharmaceutical interventions shown to have debilitating side-effects, she candidly presents ECT as a problematic therapy demanding greater scrutiny, tighter control, and full disclosure about Continue reading >>

No Risk Of Diabetes After Insulin-shock Treatment.

No Risk Of Diabetes After Insulin-shock Treatment.

No risk of diabetes after insulin-shock treatment. Bock T(1), Pedersen CR, Josefsen K, Bottazzo GF, Palmer JP, Buschard K. (1)Bartholin Instituttet, Kommunehospitalet, Copenhagen, Denmark. Comment in Lancet. 1992 Aug 8;340(8815):376-7. Lancet. 1992 Jun 20;339(8808):1512-3. Prophylactic insulin treatment is effective in preventing diabetes in animalmodels of insulin-dependent diabetes mellitus (IDDM) but the safety of suchpreventive treatment in prediabetic human subjects remains unclear; insulin is a potential autoantigen that could accelerate beta-cell decompensation and onset ofIDDM. We have investigated whether insulin treatment of non-diabetic subjectsincreases the risk of subsequent development of diabetes in a retrospective studyof Danish patients who received insulin-shock treatment for psychiatricdisorders. Mean age of the 481 patients at insulin-shock treatment was 32.6(range 12.9-69.6) years. The patients received 59 (6-200) injections of 78(16-261) IU bovine/porcine insulin. Hospital records provided an average of 22.0 (0.6-51.2) years' observation. During the observation time, IDDM developed inonly 1 patient; 1.3 cases would be expected from Danish incidence data (p =0.75). Similarly, there was no significant difference between the observed numberof cases of non-insulin-dependent diabetes mellitus (NIDDM) and the numberexpected from Danish prevalence data (12 vs 10.2; p = 0.45). We collected bloodsamples from 27 of the patients. All but 2 (who had previously diagnosed NIDDM)had normal fasting blood glucose and plasma insulin concentrations, none hadislet-cell antibodies, and only 2 had detectable insulin antibodies. Thus, therisk of diabetes was not increased by the use of many insulin injections in thesenon-diabetic subjects. We conclude that clinical tria Continue reading >>

Shock Therapy

Shock Therapy

Shock Therapy A patient being brought out of an insulin coma, circa 1930. The earliest form of shock therapy used in asylums was Insulin Shock. This process was extremely dangerous as it could result in comas and seizures. It was quickly replaced by Metrazol, which was followed by electroconvulsive therapy. In all cases patients had to be carefully monitored. RMHCL 1 | 2 Shock therapy has been in use in asylums since the early 1930s. The earliest form shock therapy, insulin therapy was invented by Manfred Sakel in 1933 as one of the first treatments that involved inducing comas or seizures. Sakel first tested his treatment on "addicts" and "neurotics," and seeing some improvement in their condition reasoned that it might be a viable treatment option for patients with schizophrenia. Sakel recorded that "the convulsions and comas of the deep shock brought about dramatic psychological changes in the patient. . .the indications were rather that the physiological shock restored the homeostasis in the nerve cell by forcing it to mobilizing its defence reactions, thus causing a restoration of the balance in the automatic nervous system. . .In this, [he] thought, lay the curative efficacy of the Insulin Shock Treatment." In 1939, the former London Asylum opened its Metrazol clinic. Metrazol replaced insulin therapy in most of the Ontario asylums as it was easier to administer than insulin shock. Metrazol was first used in clinical experiments by Hungarian physician, Ladislaus von Meduna in 1933. Meduna reasoned that artificially induced epileptic convulsions might "cure" schizophrenia due to his observations of patients who had both epilepsy and schizophrenia. Meduna noticed that those patients who had epileptic seizures would experience a remission of their symptoms of schizop Continue reading >>

Insulin-comatose Therapy

Insulin-comatose Therapy

Insulin therapy is the general name for insulin-based therapies; in psychiatry - a method of treating mentally ill patients with large doses of insulin, causing a coma or subcomatous condition, called insulin-shock or insulin-co-therapy (IT). In modern conditions, the typical and most frequent indication for carrying out IT is an acute attack of schizophrenia with a predominance of hallucinatory-paranoid symptoms and a short duration of the process. The closer the onset of the onset of the disease, the greater the chance of success. If the disease has a long chronic character, then IT is rarely used, mainly in a paroxysmal course of the process. Insulinocomatous therapy as an intensive method of treatment is used for recurrent schizophrenia with psychopathological syndromes (in particular, Kandinsky-Clerambo syndrome) and schizoaffective psychoses with pronounced resistance. Subcomatous and hypoglycemic doses of insulin can be prescribed for involuntary psychoses, prolonged reactive states, MDP. A special case when there is practically no alternative to IT is acute schizophrenic psychosis with complete intolerance to psychopharmacotherapy. Indications for forced IT do not differ from the indications for standard IT. Insulin-comatose therapy increases the duration of remission and improves their quality. Conduction of insulin-mediated therapy requires mandatory registration of the patient's informed consent (except for urgent cases). For incapacitated or underage patients, consent is given by their legal representative. Before the course of IT in the medical history, the conclusion of the clinical and expert commission is made. To conduct IT, you need a separate room, equipped with the necessary tools and a set of medicines, a nurse trained in this technique, and a para Continue reading >>

Effectiveness Of Insulin Coma In The Treatment Of Schizophreniaa Control Study

Effectiveness Of Insulin Coma In The Treatment Of Schizophreniaa Control Study

Introduction The present study was undertaken in an effort to learn whether insulin coma therapy (ICT) per se had any effect in bringing about an improvement in cases of schizophrenia. This was an attempt to compare groups of truly similar patients in a setting where the only large variable would be the insulin itself. For this purpose it was necessary that all patients be placed directly in the insulin environment and subjected to the same procedures. The methods will be discussed later.The literature concerning the validity of insulin coma therapy is extensive, and the variety of resulting conclusions about the problem is just as extensive. Investigators have concluded that ICT itself is of definite benefit in the treatment of schizophrenia,1-3 that insulin coma is of no advantage,4,5 or that it may possibly be a detriment.The inconsistency of these results may have resulted from one or more Continue reading >>

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