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Insulin shock therapy, perhaps more accurately known as insulin coma therapy, was a form of psychiatric treatment used to treat schizophrenia in the early 20th century. Psychiatrists of the era believed that states of physiological shock could help control the symptoms of mental illness. This therapy was usually used to induce physiological shock in the form of a hypoglycemic coma. Other forms of shock therapy used at the time included metrazol shock therapy and induced malarial fever. Only one form of physiological shock therapy, electro-convulsive therapy or ECT, is still in use today.
Many people believe that, at the beginning of the 20th century, the psychiatric community lacked an accurate understanding of the causes of mental illness. Some psychiatrists of the era believed that mental illnesses were purely caused by personality or behavior problems, or by past emotional trauma. Others believed that there might be physical or biological components to many mental illnesses. Treatment of mental illness is believed to have been somewhat rudimentary prior to the 20th century, when advances in mental health treatments began to take place.
Prior to the 20th century, many patients suffering mental illness lacked any kind of treatment for their illness, or any support in coping with or managing their illnesses. While advances in psychotherapy, such as those developed by Sigmund Freud, proved helpful for many patients suffering from neurotic mental disorders, psychoaffective disorders, such as schizophrenia, remained almost impossible to treat.
Physicians and psychiatrists had long noticed improvements in psychiatric symptoms in mentally ill patients recovering from severe fever or other forms of physiological shock. Treatments such as insulin shock therapy, metrazol shock therapy, and electro-convulsive shock therapy grew out of the belief that inducing states of physiological shock, including coma or convulsions, can help relieve the symptoms of mental illness.
Insulin shock therapy relies on the use of insulin, a natural metabolic hormone, to induce hypoglycemic coma in the patient. German psychiatrist Dr. Manfred Sakel is credited with pioneering this technique, which he first used to treat the symptoms of drug withdrawal in patients addicted to opiates. Dr. Sakel found that low doses of the hormone insulin improved patients' moods and relieved their physical withdrawal symptoms. He also found that higher doses of insulin could induce states of grogginess or confusion that often left the patients less combative for a period of time afterward.
Dr. Sakel began experimenting with insulin shock therapy for the treatment of schizophrenia in the early 1930s. He found that schizophrenic patients emerged from the hypoglycemic coma with fewer psychological symptoms, and exhibited better behavior. Unlike other forms of shock treatment, such as metrazol shock therapy, insulin shock therapy was considered relatively easy to control. The treatment was eventually abandoned, however, when psychiatrists realized that inducing hypoglycemic comas in patients could lead to permanent complications and even death.