Origins

At the turn of the century, when patients with neurosyphilis seemed to be relieved by malarial fevers, it was deemed possible to treat one illness with another (Julius Wagner-Jauregg received the 1928 Nobel Prize for Medicine for this discovery.) The observation that patients with dementia praecox (schizophrenia) were relieved of their psychosis after suffering seizures supported the concept of an antagonism of seizures and psychosis. Ladislas Meduna in Hungary noted that the concentrations of brain glial cells in patients with dementia praecox were low and in those with epilepsy were high. The theory of antagonism encouraged Meduna to raise the concentration of brain glia cells in schizophrenic patients by inducing epilepsy. On 24 January 1934, after he injected camphor-in-oil into a man with the catatonic form of schizophrenia, the patient seized and recovered without incident. Following the model of malarial fever therapy, Meduna repeated the injections every 3 days, and after the fifth seizure, the patient, for the first time in 4 years, fed and cared for himself and talked spontaneously. After three additional treatments he recovered, and he was well when Meduna left Hungary in 1939.(1)

Seizures induced chemically, with either camphor or pentylenetetrazol (Metrazol), were rapidly adopted worldwide as the treatment for dementia praecox, but the procedure was painful and so alternative means were sought. In 1938, Ugo Cerletti and Luigi Bini, in Rome, demonstrated the ease of administration and the efficiency of electrically induced seizures. Within a short while, these became the standard form of convulsive therapy and remain so today.

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