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[Potentiation insulin coma therapy by regional and lateral electric stimulation].

Clinicopsychopathological and clinicostatistical methods were employed to explore reverse dynamics of psychopathological symptomatology in the course of insulin coma therapy of 200 schizophrenic patients. 90 patients received insulin coma therapy in combination with zonal and lateral stimulations by means of subsensory pulse current at a frequency of 1 to 30 Hz. Right hemispheral exposure potentiated antipsychotic action of insulin comas. After left hemispheral exposure insulin comas provoked temporary exacerbation of symptomatology. The new modification was called lateral potentiated insulin coma therapy. The use of the therapy made it possible to attain a more rapid reverse development of psychotic symptomatology, to reduce the number of comas required per treatment course, to raise the quality and duration of the remissions attained.

Combined Modality Therapy

[Effect of psychopharmacotherapy on the course of forced insulin-coma treatment of patients with paranoid schizophrenia].

The course of forced insulin-coma therapy in cases of preliminary employment of psychotropic drugs (mainly derivatives of phenothiazine or leponex) may be attended by variable forms of deviations including serious complications whereas they are not encountered in cases of treatment with haloperidol and pharmacologically similar long-acting drugs. These findings justify the employment, when necessary, of the above drugs in combination with forced insulin-coma therapy.

Adolescent

[Forced insulin coma therapy and its efficacy].

The title method was applied to the treatment of schizophrenic patients suffering from schizoaffective, paranoid and hallucinatory paranoid attacks. Definite correlations were established between the development of insulin coma and the type of the reverse development of psychosis. Five variants of schizophrenia reduction due to the treatment method under consideration were distinguished and described: variant 1--harmonic critical, variant 2--harmonic lytic, variant 3--disharmonious deliric, variant 4--disharmonious affective, and variant 5--incomplete reduction. The established correlations between variants of the development of insulin coma and the type of psychosis reduction enable one to predict whether the use of forced insulin coma therapy will be desirable and effective.

Chronic Disease

Insulin coma therapy: decrease of plasma tryptophan in man.

A biochemical study was performed in two patients submitted to insulin coma therapy. The injection of insulin resulted in a decrease of free and total tryptophan as well as tyrosine in plasma, while NEFA were not influenced by this treatment. The ratio of tryptophan to tyrosine was enhanced. The administration of glucose after insulin provoked an increase of free and total tryptophan. The results support the hypothesis that in man insulin may favor the uptake of tryptophan by the brain, and enhance the synthesis of cerebral serotonin.

Adult

[The place of insulin coma therapy among the current methods of treating patients with paroxysmal schizophrenia].

The efficacy of intensive insulin coma therapy (IICT) and individually adjusted psychopharmacotherapy (IAT) was studied in schizophrenics in a month after the treatment initiation. Comparison of the efficacy of these 2 methods showed that the insulin treatment led to a sharper differentiation between patients with favourable and unfavourable therapeutic effect. The duration of schizophrenia did not affect the results of IICT. This method was more effective in schizoaffective syndromes in the framework of periodic schizophrenia, as well as in paroxysmal schizophrenia when it closely resembled the former. IICT was poorly effective in neurosis-like and hallucination-paranoid syndromes in the framework of the continuous course of schizophrenia. The rate of disappearance of psychotic symptomatology in the insulin therapy correlated with the degree of the course therapeutic effect.

Adult

[Effect of prior psychopharmacotherapy on the development, clinical course and therapeutic effect of insulin coma in patients with schizophrenia].

In 123 patients the peculiarities of formation and effectiveness of insulin coma (IC) were studied under drug therapy as compared with 49 drug-free patients. Pharmacotherapy preceding the ICs produced uneven effect on its course. Artefact course of IC was most frequently observed after mageptil, chlorpromazine melipramine treatment, and to a lesser extent--after haloperidol, triphtazin, amitriptyline. It was virtually absent after benzodiazepines. The autonomic manifestations in IC and the harmony if its development and clinical picture, markedly changing under drug treatment, were exposed as predictors of the efficiency of IC therapy.

Adult

[Amino acid reserves of the blood in patients with schizophrenia and their correction in insulin coma].

Free amino acid content was measured in the blood serum in patients with permanently progressive paranoid schizophrenia under conventional insulin shock therapy. The influence of several amino acids (methionine, glutamic acid) preinjection on their base levels was also assessed. Metabolic response to the insulin coma was different in preinjected vs. control groups. Glutamine acid-preinjected patients displayed less pronounced shifts in amino acid reserves in the blood serum that smoothed the shock-related metabolic stress in these patients as related to conventional shock.

Amino Acids