Insulin shock happens when there is too little or too much insulin in the human body. It occurs in cases where the patient has not eaten for a long time or engaged in physical activity. The main symptoms of insulin shock are clouding of consciousness, dizziness, and a fast, weak pulse. Sometimes there are convulsions.
In psychiatry
Besides this, insulin shock began to be used in psychiatry. Specialists artificially caused a hypoglycemic coma by injecting insulin into a person. For the first time, this method of therapy was used by Sackel in 1933. He was a specialist in the treatment of heroin and morphine addicts.
As a result of the introduction of insulin into the body, patients experienced insulin shock. It must be taken into account that this method caused a rather high mortality rate. In 5% of cases, the consequences of artificially induced insulin shock were fatal.
During clinical studies, it was found that this technique isineffective. The implications of insulin shock in psychiatry have been shown to be ineffective in clinical trials. This at one time caused a wave of indignation among psychiatrists who actively used such therapy. Remarkably, insulin shock treatment of schizophrenia was used until the 1960s.
But over time, information that the effectiveness of this method was overestimated began to spread actively. And the therapy only worked when the patient was treated with prejudice.
In the USSR
Back in 2004, A. I. Nelson noted that insulin shock therapy is still considered one of the most effective in the country. It is noteworthy that American psychiatrists who visited Soviet hospitals in 1989 noted that coma induced in this way was used on the territory of the country against people who did not have signs of psychotic or affective disorders. For example, treatment with insulin shock was mandatory for dissidents.
But at the moment, the use of this method is largely limited. But at the same time, it must be remembered that insulin shock is used only in cases where other therapy has been ineffective. But there are regions where this method is not used at all.
Indications
The main indication for the use of insulin shock are psychoses, schizophrenia in the first place. In particular, hallucinatory, delusional syndrome is treated by this method. It is believed that such therapy has an antidepressant effect. But, according to official statistics, in somecases, such therapy leads to deterioration, not improvement.
How to apply
A special ward is allocated for the patient, special training of personnel is required, constant monitoring of the patient in a coma. Be sure to follow the diet. Very laborious treatment for poor condition of the veins.
Side effects
Be aware that the therapy itself has a painful effect. Therefore, the method is not very popular. Insulin shock is combined with profuse sweating, agitation and a strong feeling of hunger, convulsions. Patients themselves described the treatment as extremely painful.
Besides this, there is a risk that the coma will drag on. A coma may also occur. In some cases, insulin shock leads to death. Such therapy also has contraindications.
About the effect
Initially, insulin shock was caused only in the mentally ill who refused to eat. Later it was noted that the general condition of patients after such therapy improves. As a result, insulin therapy began to be used in the treatment of mental illness.
Insulin is currently used for the first attack of schizophrenia.
The best effect is observed in hallucinatory-paranoid schizophrenia. And the least shows insulin therapy in the treatment of a simple form of schizophrenia.
It must be remembered that acute hepatitis, liver cirrhosis, pancreatitis, urolithiasis arecontraindications to the use of insulin.
This treatment is also not recommended for patients suffering from malnutrition, tuberculosis, brain diseases.
Insulin coma is achieved by intramuscular injection of insulin. Usually find the minimum required dose, gradually increasing the number of doses. Begin by introducing four units of this compound.
The first coma should not last longer than 5-10 minutes. Then her symptoms stop. The duration of the coma can be increased up to 40 minutes. The course of treatment is usually approximately 30 com.
Stop the manifestations of coma by injecting 40% glucose solution. As soon as the patient comes to his senses, he is given tea with sugar and breakfast. If he is unconscious, tea with sugar is administered through a probe. Introduction to coma is carried out every day.
Starting from the second and third phases of insulin therapy, the patient develops drowsiness, impaired consciousness, and muscle tone decreases. His speech is slurred. Sometimes body patterns change, hallucinations begin. Often there is a grasping reflex, convulsions.
In the fourth phase, the patient becomes completely immobile, he does not react to anything, muscle tone increases, sweat is plentiful, and the temperature drops. His face becomes pale and his pupils become narrow. Sometimes there are respiratory disorders, cardiac activity, all these symptoms are accompanied by amnesia.
Complications
Such an impact on the body cannot but give complications. They manifest themselves in the fall of cardiac activity, heart failure,pulmonary edema, recurrent hypoglycemia. If complications begin, hypoglycemia is interrupted by administering glucose, and then vitamin B1, nicotinic acid is used.
Questions
The mechanism of the action of insulin on the course of mental illness is still very mysterious. It was possible to find out that insulin coma affects the deepest brain structures. But at the moment, science cannot determine exactly how this happens.
It is important to note that a similar effect was once observed in lobotomy. It was believed that she helped to "pacify" the sick, but the effect was shrouded in secrets. And only years later, the crippling nature of this procedure was clarified, which often led to horrific and opposite expected consequences.
In the West, insulin therapy is currently not even included in psychiatric training programs. It is simply not recognized as effective. This treatment is considered extremely painful, causes many complications, side effects, and can even lead to death.
But proponents of insulin therapy continue to claim that the method works. And in a number of countries, including Russia, it is still practiced for patients with schizophrenia. It is believed that such treatment allows patients to forget about their illness for years. And sometimes even supportive therapy is not needed. Not every method of treatment in psychiatry gives such a result. At the same time, insulin therapy is never used without an appropriate expert opinion, as well as written consent.directly to the patient.
Difficulties in psychiatry
Psychiatry is a fairly complex science. While doctors in other areas have accurate diagnostic methods - using devices that clearly demonstrate the signs of the disease, psychiatrists are deprived of such opportunities. There is no technique for diagnosis, control over the patient's condition. Psychiatrists are forced to rely only on the words of the patient.
Facts like these, as well as egregious cases from psychiatric practice, led to the flourishing of the anti-psychiatry movement. Its representatives questioned the methods used by doctors. The movement began in the 1960s. His supporters were concerned about the blurring of the diagnosis of mental disorders. After all, each of them was too subjective. Also, the therapy used often did more harm than good to patients. For example, in fact, lobotomy, which was massively carried out in those years, was recognized as criminal. I must say that she really turned out to be crippling.
In the 1970s, Dr. Rosenhan did an interesting experiment. At his second stage, he reported to the psychiatric clinic that she would reveal the malingerers that he would send. After many malingerers were caught, Rosenhan admitted that he did not send malingerers. This caused a wave of indignation that rages to this day. It was found that mentally ill people just easily distinguished "their own" from mishandled persons.
As a result of the activities of these activists, the number of patientspsychiatric clinics in the US fell by 81%. Many of them have been released and released from treatment.
Method Maker
The fate of the creator of insulin therapy was not easy. Most of the civilized countries recognized his method as the main mistake of psychiatry of the 20th century. Its effectiveness was debunked 30 years after its invention. However, until that moment, insulin coma had managed to take a lot of lives.
Manfred Szekel, as he was called towards the end of his life, was born in the city of Nadvirna in Ukraine. But it is noteworthy that during his life this area managed to pass into the citizenship of Austria, Poland, the USSR, the Third Reich, Ukraine.
The future doctor himself was born in Austria. And after the First World War, he lived in this country. After receiving a specialized education, he began working in a Berlin psychiatric hospital, mainly treating drug addicts.
At the same time, a new way to treat diabetes was discovered, which became a breakthrough: widespread use of insulin against diabetics began.
Zeckel decided to follow this example. He began using insulin to improve the appetite of his patients. As a result, when some overdose patients fell into a coma, Zekel noted that such a phenomenon had a positive effect on the mental status of drug addicts. Their breakouts decreased.
With the rise of the Nazis, Seckel returned to Vienna, where he continued to develop insulin-based drugs for the treatment of schizophrenics. He increased the dosage of this substance and called his method insulin shock therapy. At the same time, it was revealedlethality of this method. It could reach 5%.
And only after the war, when the painful method of therapy was used very actively, the article "The Myth of Insulin" was published, which refuted the effectiveness of such treatment.
After 4 years, this method was subjected to experiments. For example, in one of them, schizophrenia was treated with insulin in some patients and barbiturates in others. The study found no difference between the groups.
This was the end of insulin shock therapy. In fact, in 1957, Dr. Zekel's life's work was destroyed. For some time, the method continued to be used by private clinics, but already in the 1970s it was safely forgotten in the United States and in European clinics. But in the USSR and the Russian Federation, insulin therapy is still included in the standards of treatment for schizophrenia, despite the fact that it is considered the “method of last resort.”
