Technique
Insulin coma therapy was a labour-intensive treatment that required trained staff and a special unit. Patients, who were almost invariably diagnosed with schizophrenia, were selected on the basis of having a good prognosis and the physical strength to withstand an arduous treatment. There were no standard guidelines for treatment; different hospitals and psychiatrists developed their own protocols. Typically, injections were administered six days a week for about two months.
The daily insulin dose was gradually increased to 100–150 units until comas were produced, at which point the dose would be levelled out. Occasionally doses of up to 450 units were used. After about 50 or 60 comas, or earlier if the psychiatrist thought that maximum benefit had been achieved, the dose of insulin was rapidly reduced before treatment was stopped. Courses of up to 2 years have been documented.
After the insulin injection patients would experience various symptoms of decreased blood glucose: flushing, pallor, perspiration, salivation, drowsiness or restlessness. Sopor and coma—if the dose was high enough—would follow. Each coma would last for up to an hour and be terminated by intravenous glucose. Seizures sometimes occurred before or during the coma. Many would be tossing, rolling, moaning, twitching, spasming or thrashing around.
Some psychiatrists regarded seizures as therapeutic and patients were sometimes also given electroconvulsive therapy or cardiazol/metrazol convulsive therapy during the coma, or on the day of the week when they didn’t have insulin treatment. When they were not in a coma, insulin coma patients were kept together in a group and given special treatment and attention; one handbook for psychiatric nurses, written by British psychiatrist Eric Cunningham Dax, instructs nurses to take their insulin patients out walking and occupy them with games and competitions, flower-picking and map-reading, etc. Patients required continuous supervision as there was a danger of hypoglycaemic aftershocks after the coma.
In "modified insulin therapy", used in the treatment of neurosis, patients were given lower (sub-coma) doses of insulin.
Read more about this topic: Insulin Shock Therapy
Famous quotes containing the word technique:
“The moment a man begins to talk about technique that’s proof that he is fresh out of ideas.”
—Raymond Chandler (1888–1959)
“The more technique you have, the less you have to worry about it. The more technique there is, the less there is.”
—Pablo Picasso (1881–1973)
“In love as in art, good technique helps.”
—Mason Cooley (b. 1927)