A history of insulin coma therapy in Australia

Abstract

The negative period between the wars came to an end with the discovery of the biological therapies, including ICT, a development of great interest to Australian psychiatrists. Melbourne psychiatrist Reg Ellery documented his use of ICT in 1937, but the evidence shows that he was beaten to it by Farran-Ridge and Reynolds at Mont Park. ICT was soon used at various centres, but phased out by the late fifties. A review follows of its use in Australia and a discussion of the issues involved. Doing ICT played a part in enhancing the professional status of Australian psychiatrists and was one of the factors that led to the establishment of the AAP in 1946.

Understanding the experience of women admitted to a psychiatric hospital in Sydney with psychosis or mania following childbirth after World War II (1945–1955)

“…ICT involved giving patients increasing doses of insulin to provoke a hypoglycaemic coma over a 3‐hour period. The patients were revived with dextrose, and given a high carbohydrate breakfast (Kaplan ). However, the coma could not be reversed in some patients (Adams ), and the therapy was gradually phased out in Australia during the 1950s (Kaplan ).…”

“…The patients were revived with dextrose, and given a high carbohydrate breakfast (Kaplan ). However, the coma could not be reversed in some patients (Adams ), and the therapy was gradually phased out in Australia during the 1950s (Kaplan ). Consent for these treatments was obtained from the women's husbands, demonstrating their powerlessness and lack of self‐agency during their admissions.…”

“…However, by the 1940s, the diagnosis of psychosis and mania had been classified into symptoms. Physical treatments, such as electroconvulsive therapy (ECT) and insulin coma therapy (ICT), were introduced (Garton ; Kaplan ) alongside therapeutic agents, such as the sedative and antiepileptic agent bromide, also given during labour to prevent eclampsia (Helliwell & Hutton ). Therefore, the present study discusses how these new ideas and subsequent treatments affected the women, and considers if there were alternative explanations that could explain the women's symptoms.…”

‘A landmark in psychiatric progress’? The role of evidence in the rise and fall of insulin coma therapy

“…Insulin coma therapy was rapidly adopted across Europe and North America, and by 1939 was being promoted by governmental public health bodies, and favourably reported in the mainstream media (Adams, 2014). It continued to be used until the early 1960s, but by the late 1960s the treatment had largely been abandoned, although there are some reports that it continued to be used in Australia as late as 1974, and in China in 1985 (Kaplan, 2013).…”

Publish or perish: Dr Victor Webster and cardiazol treatment in Western Australia, 1937–1938

“…There is a small body of published research on the introduction of convulsive therapies in Australian psychiatric hospitals before the electrical convulsive therapy era. [1][2][3][4] The chronology established by Mitchell and Sengoz indicates that Ellery and Lear were the first to publish a study detailing the use of cardiazol in Australia, in April 1938. Most early Australian publications came from clinicians working on the eastern seaboard of Australia, and these earliest findings were all published in the Medical Journal of Australia.…”