Insulin shock

Dosage adjustments Closely observe every patient exhibiting insulin resistance who requires concentrated insulin for diabetic control until appropriate dosing is established. Response will vary among patients. Most patients will show a tolerance to insulin, so that minor dosage variations will not cause untoward symptoms of insulin shock. Some may require only 1 dose daily others may require 2 or 3 injections per day. 

Perform cardiopnlmonary resuscitation if necessary If victim is in a coma, administer naloxone hydrochloride (in narcotic or opioid overdose) and 50% glucose (in case of insulin shock)... 

Impastato, D.J., Gabriel, A.R., and Lardaro, H.H. (1964) Electric and insulin shock therapy during pregnancy. Dis Nerv Syst 1 542-546. 

Pulmonary edema secondary to hypoglycemia was reported particularly in the 1930s when insulin shock treatment was used for schizophrenia. It is less common nowadays, but has been reported after insulin overdose (16). 

Respiratory effects of hypoglycemia A 19-year-old woman with diabetes developed hypoglycemia with pulmonary edema (59). This has previously been seen as a complication of insulin shock therapy for psychiatric illnesses. 

Dextrosecarboxylic acid, I, 3 Diabetes, effect of glycerol on insulin shock, I, 177... 

While insulin shock therapy is applicable mainly in cases of schizophrenia in their comparatively early stages, electro-shock therapy is applicable to manic depressive psychoses and to involutional... 

We believe that L.S.D.-25 is a drug which induces a controllable toxic state within the nervous system, that reactivates anxiety and fear with apparently just enough euphoria to permit recall of the provoking experiences. It does this without the sluggishness or speech difficulties so frequently encountered during I.S.T. [Insulin Shock Therapy] and following E.C.T. [Electroconvulsive Therapy]. 

Other somatic therapies were developed in the first half of the twentieth century, with variable results. Malaria therapy was conceived in 1917, insulin shock in 1927, psychosutgery in 1936, and electroconvulsive treatment (ECT) in 1938. All of these methods, as originally conceived, carried serious risks, and most demonstrated marginal effectiveness. Psychosurgeries were carried out by the thousands in the 1940s, resulting in rather effective behavioral control over agitated psychotic patients... 

The first half of the 20th century brought further attempts to use drugs and other therapies to treat mental illness. For example, tests were conducted on the effectiveness of giving amphetamines to depressed and narcoleptic patients, and carbon dioxide inhalation procedures were used in the treatment of illnesses referred to as psychoses and neuroses. Also used in the treatment of psychoses were antihistamines, insulin shock, and psychosurgery. Electroshock therapy was used to treat severe depression (a procedure still used today). Finally, in 1949 an Australian physician named John Cade discovered that the alkali metal lithuim successfully moderated manic conditions, although concerns about toxic reactions to it prevented its approval for use in the United States until 1970. Lithium remains a mainstay in the treatment of bipolar illnesses today. 

Extreme caution is necessary in the measurement of dosage inadvertent overdose may lead to an irreversible insulin shock. Serious consequences may result if insulin is not used under constant medical supervision if an overdose is untreated, hypoglycaemia may lead to convulsions and coma which should not be confused with hyperglycaemic coma. 

Insulin shock may also occur due to the EDTA treatment lowering the serum glucose. Regular food intake during the chelation treatment will help to prevent this. 

Many victims of mental disease are said to show disturbances of carbohydrate metabolism. Indeed, the physiological and biochemical study of mental diseases is in its early infancy. Preliminary findings suggest that the time is ripe for full-scale attack upon mental diseases by the techniques of these sciences. The insulin shock treatment represents only a first crude application of physiological techniques to therapy of such conditions. More effective methods may be expected to evolve out of this beginning. 

Beta-receptor antagonists mask the symptoms of hypoglycemia (e.g., tachycardia, diaphoresis). and thus mask the symptoms of insulin overdose. This could lead to insulin shock. 

Manfred Sakel of Vienna introduces insulin shock treatment into psychiatry. 

Hypoglycemic reaction (insulin shock) Headache, lightheadedness, nervousness, apprehension, tremor, excess perspiration cold, clammy skin, tachycardia, slurred speech, memory lapse, confusion, seizures Blood sugar <60 mg/dL... 

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