Insulin Shock Therapy

Insulin shock therapy is an outmoded treatment for schizophrenia, which involved administering sufficient insulin to put the patient into a coma for a short time.

Large doses of insulin cause hypoglycemia which, left untreated, results in a state of coma. The controlled use of insulin in the treatment of diabetes is well known, but it application to the major psychotic condition schizophrenia was novel when Manfred Sakel (1900–1957) at the University Neuropsychiatric Clinic, Vienna, first developed it during the 1930s. The treatment was adopted widely and endorsed by leading figures in psychiatry. Insulin shock therapy was finally discredited following a milestone 1953 publication in The Lancet, the leading medical journal by British psychiatrist Harold Bourne (1923–).

Insulin shock therapy, also known as insulin coma therapy, was one of three significant physical treatments for schizophrenia to emerge in the 1930s. The other two were leucotomy and electroconvulsive, or electric shock, therapy (ECT). Of the three, only ECT continued to be used into the twenty-first century, and its use is controversial. Drug treatment was the main approach to managing schizophrenia in the early 2000s.

However, insulin shock therapy was popular among doctors in its day. Patients were given insulin until they entered deep coma for a period of up to 15 minutes. An injection of glucose terminated the coma. Typically, patients had about 50 treatments. A high staffing level was needed to care for patients in special insulin units.

There was never any sound scientific basis for insulin shock therapy. This fact was exposed by Harold Bourne in his Lancet paper entitled “The Insulin Myth.” It is perhaps surprising that the practice persisted for so long and that more patients were not harmed by the procedure.

See also Leukotomy (prefrontal lobotomy).

KEY TERMS

Hypoglycemia—
A state of abnormally low blood glucose levels that may lead to coma, because the brain has a high requirement for glucose.
Insulin—
A hormone, secreted by the pancreas, which promotes the absorption of glucose from the blood.
Schizophrenia—
A long-term psychotic condition marked by symptoms such as auditory hallucinations, delusions, and abnormal behaviors, including social withdrawal.

Resources

BOOKS

Whitaker, Robert. Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, 2nd ed. New York: Basic Books, 2010.

PERIODICAL

Jones, Kingsley. “Insulin Coma Therapy in Schizophrenia.” Journal of the Royal Society of Medicine 93, no. 3 (March 2000): 147–49.

WEBSITE

Sabbatini, Renato M. E. “The History of Shock Therapy in Psychiatry.” http://www.cerebromente.org.br/n04/historia/shock_i.htm (accessed July 15, 2015).