A Brief History of Electroshock

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Hippocrates was the first to observe that malaria-induced convulsions in

insane patients was able to bring a reduction in their symptoms.

 

Middle ages. Physicians note that high fevers occuring with infection

epidemics in asylums appear to have a calming effect on the insane.

 

During these times, several physicians noted that few epileptics suffered

from schizophrenia (actually the correlation is very high) leading to a common

theory that the two conditions are incompatible.

 

In 1917, Julius Wagner-Jauregg introduces the malaria-induced fever to

treat neurosyphillitic paresis.

 

In 1927, Manfred Sakel introduces the insulin-induced coma and convulsions

to treat schizophrenia.

 

1934 Meduna introduces the cerebral agitating agent Metrazol to chemically

induce convulsions for schizophrenia.

 

 

 

 

 

The belief that epilepsy is incompatible with schizophrenia is a curious one. We

now know this belief to be utterly false and curious some people with manifest

schizophrenia will calm down when administer anti-convulsant drugs such as

carbamazipine. Just for the record, father of transactional analysis, Eric Berne

also noted a correlation between schizophrenia and an absence of asthma. Maybe

we could try inducing asthma...

 

" Sakels Technique " of inducing convulsions using insulin were received worldwide

by 1933. " Insulin Shock " was brought about by giving an unfed patient a large

injection of insulin thereby inducing a hypoglycemia reaction resulting in

hypoglycemic convulsions. The patient would be revived by passing a tube via the

nose into the stomach and passing glucose fluid into the stomach to raise blood

sugars. The " procedure " is portrayed in the film " A Beautiful Mind " and in Paulo

Coelho's book, " Veronika Decides to Die " . According to a 1939 American

Psychiatric Association study, of 1757 recipients of insulin shock, 11 % were

said to have had a prompt and total recovery, 26.5 % were " greatly improved " and

26 % had some improvement. Since an adult human brain normally extracts about 60

to 80 milligrams of glucose per minute from circulating blood depriving it of

essential glucose is not necessarily a good thing.

 

Extensive brain damage can occur, particularly to the sensitive area of the

hippocampus (involved with memory) and the cerebellum (balance, coordination).

Diabetics are usually very keen to avoid dangerous situations such as insulin

shock whilst psychiatry induced them in a manner suggesting that the damage was

the cure.

 

The story of Ugo Cerletti and the abattoir are well known by now. Convulsions

were already being introduced into patients, primarily via insulin shock and the

use of the cerebral agitation agent, metrazol. Glucose could be used to abort

insulin induced convulsions, however metrazol had no 'antidote' and was most

feared by patients, not all of whom ever actually consented to being given this

dreadful " treatment " . Cerletti observed pigs being stunned with electric prods

to their heads prior to slaughter to render the animal more manageable for the

slaughterhouse staff. Not surprising then that this method should quickly

transfer across to the overcrowded psychiatric units of the time (don't be

mistaken - if you think that it isn't done any more, or that it is a rarity, you

are seriously mistaken. It is not banned and is still a very common 'treatment',

especially for 'agitated' little old ladies in nursing homes who want to " go

home " .)

 

Cerletti and colleagues practiced shocking animals (mostly dogs) until they came

up with what they considered a safe and reliable procedure. On administration of

shocks to people (at the time without muscle relaxant nor anaesthetic)

recipients were often found to have retrograde amnesia. This means that they

often did not remember receiving electroshock, nor the period of time

immediately prior to the procedure. Thus the patients carried no negative

perception of the electroshock itself. Used primarily on schizophrenics,

Cerletti and teams found the results " remarkable " . Strange, since these days ECT

is said to have no role in the treatment of chronic schizophrenia and is

generally considered to be of most value in the treatment of depression.

 

ECT grew in popularity with only a few modifications (including the introduction

of light anaesthetic and muscle relaxant to try and reduce the number of bone

fractures occurring during the convulsion) and today approximately 150,000

patients receive electroshock per year.

 

 

 

Anyone got an aspirin?

 

 

.In one of the most authoritative psychiatric texts Kaplan (1997) writes:

" Because ECT requires the use of electricity and the production of a seizure,

many laypeople, patients and patients' families are understandably frightened by

the procedure. Many inaccurate reports have appeared in both professional and

lay literature about alleged permanent brain damage resulting from ECT. Although

these reports have largely been disproved, the spector of ECT-induced brain

damage remains. "

 

This is strange. Maybe the numerous people that have contacted me with

varying neurological syndromes that they attribute directly to their ECT

" treatments " including epilepsy, tics, dystonias, parkinsonism, memory

disorders, lack of concentration etc are all being " inaccurate " .

 

Despite all modern research, patients charters, improved civil rights,

etc, David J. Rothman stated in an NIH Consensus Conference on ECT in 1985: " ECT

stands practically alone among the medical/surgical interventions in that misuse

was not the goal of curing but of controlling the patients for the benefits of

the hospital staff "

 

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