Long Acting Insulin

Photo credit: vancanjay

It’s not widely known that large doses of insulin were commonly used in psychiatric institutions in the 1940s and 1950s to treat schizophrenia and other mental illness. Insulin shock therapy was regarded as the treatment of choice for schizophrenia for about twenty years, enjoying uncritical acceptance in Europe and America.

The “treatment” was considered a type of shock therapy. Patients were given regular insulin injections to produce five or six diabetic comas a week for weeks at a time. Insulin therapy continued until the patient improved, or until 50 to 60 comas had been induced.

The originator of insulin shock therapy, also known as insulin coma therapy, was Dr. Manfred Sakel. The Polish doctor stumbled upon the therapy accidentally while working in Vienna, when a patient in whom he’d provoked an insulin coma showed a remarkable improvement in her mental functioning.

Sakel practiced and popularized insulin therapy in Europe, and introduced it to the US after he emigrated from Austria to New York in 1936. The practice of insulin dosing continued into the 1960s in America, and for much longer in countries like China and the former Soviet Union.

Sakel believed that the seizures and unconsciousness experienced by psychiatric patients undergoing an insulin-induced hypoglycemic episode resulted in dramatic change in their mental state. In his own words: “My supposition was that some noxious agent weakened the resilience and the metabolism of the nerve cells…blocking the cell off with insulin will force it to conserve functional energy and store it to be available for the reinforcement of the cell.”

Sakel claimed that close to ninety percent of his patients improved with insulin shock therapy, but his methods were later called into question and discredited as unscientific. In particular, Sakel was accused of “cherry picking” the patients most likely to improve using insulin therapy, and providing them with extra attention and support.

Patients were said to have been terrified of the procedure, which is now considered to be inhumane. Severe hypoglycemia such as that induced by Sakel can result in permanent brain damage and even death. Some of his insulin therapy patients did indeed suffer adverse effects, including fatalities. While today’s antipsychotic medications are not without their side effects, thankfully they are much safer and more effective than anything available just a couple of decades ago.