Insulin shock therapy

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

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. 

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]. 

Fever elevates the blood GSH index (17-20). The degree of temperature elevation and the duration of hyperpyrexia cannot be correlated with the level of the GSH concentration. The mechanism underlying this effect of fever is not known the coincident elevated metabolic rate is not responsible because experimental hjrperthyroidism in animals lowers the blood GSH index (21-25). Stress in a general sense is perhaps a factor since electric and insulin shock therapies both raise the index after 2 to 6 hr., as do injections of epinephrine and insulin following a similar time interval (26-29). However, ACTH injections in normal man may cause no change or may lower the GSH concentration (30-38). The elevating effect of fever might simply be related to accelerated protein catabolism. 

Shock Therapy. The early 20th century saw the development of the first effective biological treatments for depression, the shock therapies. The first shock treatments used injection of horse serum or insulin. A major advance in treatment occurred with the advent of electroconvulsive therapy (ECT) in 1934. Although initially used to treat schizophrenia, ECT was soon found to be highly effective for other psychiatric disorders including depression and mania. ECT remained the primary biological psychiatric treatment until the widespread release of psychiatric medications in the 1950s. 

Shock Therapy. Insulin coma treatments were used in the early 1900s but offered no tangible improvement. Electroconvulsive therapy (ECT) arose in the 1930s and 1940s and was the hrst treatment to provide some relief from psychosis. However, its effects are only temporary and it proved too costly for continuous use. ECT continues to have some use for life-threatening catatonia, but it is mainly used to treat refractory depression or bipolar disorder. 

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. 

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. 

The mean GSH index in psychotic patients (schizophrenia, manic-depressive psychosis, and involutional melancholia) ranges from 25 to 35 mg. per 100 cc. packed RBC (standard deviation 6.1) and the mean normal GSH index ranges from 63 to 93 mg. per 100 cc. packed RBC (standard deviation 11.3) as determined by six (56-61) groups of investigators during the past twenty years. Insulin and electric shock therapy raise the GSH content of the blood in these patients (61-63). 

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