Sleep as a cure for schizophrenia: a historical episode

Abstract

In the early 1920s, the Swiss psychiatrist J. Kläsi, working under the directorship of E. Bleuler at Burghölzli, the Psychiatric Clinic of the University of Zürich, proposed the treatment of schizophrenia by prolonged sleep therapy induced by the hypnotic Somnifen. Judging from contemporary literature, Kläsi's proposal, which was based upon clinical experience, was accepted by many European psychiatrists, especially those in German-speaking countries. Despite some doubts as to the effectiveness of the therapy and the relatively high mortality rate associated with its use, Somnifen and other related sleep-inducing compounds, were consistently advocated by Burghölzli psychiatrists for at least a decade. It is proposed that the insistence on the use of sleep inducing compounds in the therapy of mental disorders was based on the desperation of psychiatrists lacking effective treatment of schizophrenia. The use of prolonged sleep therapy waned in the mid-1930s with the emergence of other therapies, primarily with insulin and cardiazol.

A History of the Pharmacological Treatment of Bipolar Disorder

“…That was a mixture of diethyl and dipropenyl-barbituric acid, prepared by the Swiss firm Hoffmann-LaRoche (Basel) in a process lasting at least 6–7 days. Another preparation of these characteristics was the so-called Cloetta or Cloettal mixture [ 44 , 45 ], using barbiturates rectally, amyl hydrate, alcohol, chloral hydrate, digitaline, paraldehyde and ephedrine. The main clinical indications of “sleep cures” were manic excitations and agitated depressions, although they were also tested in schizophrenia with less satisfactory results [ 41 ].…”

Ivan P. Pavlov: An overview of his life and psychological work.

“…This may have led to physiological damage to the highest regions of their central nervous system. As therapy for schizophrenia, Pavlov recommended rest and prolonged sleep that was induced by soporific pharmaceuticals (Windholz & Witherspoon, 1993).…”

La cura de sueño en la historia

“…Pese a la introducción del Cloettal, la cura de sueño prolongado declinó a partir de la segunda mitad de la década de 1930, al surgir nuevos tratamientos psiquiátricos, tales como la insulinoterapia (en 1933), las convulsiones por pentilenetetrazol (en 1935) y el electrochoque (en 1938). Pero aquel procedimiento no "pasó a la historia" del todo (como afirman Windholz y Witherspoon) (12), sino que continuó aplicándose Rev Neuropsiquiatr. 2020; 83(1):40-44 varias décadas después.…”