Insulin coma therapy
A treatment for schizophrenia in which large doses of insulin put the patient into a coma. Reported by Manfred Sakel in 1933 and widely adopted, but a controlled trial in 1957 found no effect of the insulin itself.
Insulin is the hormone that lowers the sugar in the blood. In large doses it starves the brain of sugar and the patient falls into a coma, a deep loss of consciousness from which they cannot be roused. After about three hours the patient was revived with sugar, and the procedure was repeated about thirty times. Sakel reported that 88 percent of patients early in their illness clearly improved. Deaths from the treatment were reported at 0.5 to 4.5 percent[1].
In 1957 Ackner and colleagues in London allocated fifty patients at random to two groups, one made unconscious with insulin and the other with a sleeping drug. The results did not differ[1][2]. The treatment was then displaced by new drugs that appeared at about the same time, and quietly fell out of use[1].
Related terms
- SchizophreniaAn illness in which the connections between mental functions such as thought and feeling break down. The word was coined in 1908 by the Swiss psychiatrist Eugen Bleuler.
- Electroconvulsive therapyA treatment that passes an electric current through the head to bring on a convulsion. Begun in Rome in 1938 by Ugo Cerletti and colleagues; today it is given under anaesthesia and used for severe depression.
- ChlorpromazineA drug that eases the hallucinations and delusions of schizophrenia. Synthesised in France in 1951 and tried as an aid to anaesthesia, it entered psychiatry in 1952.
Sources
- R. Freudenthal, J. Moncrieff, “'A landmark in psychiatric progress'? The role of evidence in the rise and fall of insulin coma therapy,” History of Psychiatry 33(1), 65–78 (2022).
- B. Ackner, A. Harris, A. J. Oldham, “Insulin Treatment of Schizophrenia: A Controlled Study,” The Lancet, issue 6969, 607–611 (1957).