Significance of Insulin Inhibition by Blood of Schizophrenic Patients

Goldner, Martin G.; Ricketts, Henry T.

doi:10.1001/archneurpsyc.1942.02290100052005

Cited by 7 publications

(1 citation statement)

References 11 publications

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“…Meduna and McCulloch (134) showed in these patients, called oneirophrenics, a relationship between a decreased glucose tolerance test, presence of a hyperglycemic factor in urine, and insulin resistance. Goldner and Ricketts (73) have seriously challenged the concept of an anti-insulin factor, specifically in schizophrenic blood, for they were unable to confirm the work of Meduna et al Nevertheless, insulin resistance in schizophrenics has also been described by Freeman et al (55), Freeman (53), and Harris (76). However, abnormal insulin reactions are not characteristic of all schizophrenics and are frequently found in other forms of mental disease (115).…”

Section: Carbohydrate Metabolismmentioning

confidence: 99%

Biochemical and Physiological Changes Associated with Schizophrenia.

Domino¹

1959

Psychopharmacology: Problems in Evaluation.

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As our knowledge and clinical experience with phrenotropic drugs increases it is evident that agents such as reserpine, chlorpromazine, promazine, proclorperazine, perphenazine, and others make the disturbed psychotic more manageable but still leave him psychotic (48,130). The incidence of remissions following drug therapy appears no better than that following the myriad of more drastice somatic shock therapies. These results are not necessarily disappointing, for the widespread use of phrenotropic drugs as therapeutic adjuncts in psychiatry has strengthened the view that functions of the mind are the end result of an actively metabolizing brain. By giving fresh impetus to the search for possible physiochemical abnormalities in mental disease, the present nonspecific symptomatic drug therapies have already accomplished a great deal.Since the design of more specific drug treatments is dependent upon discrete knowledge of possible biochemical and physiological aberrations associated with mental disease, it is pertinent to the objectives of this conference to review critically the available evidence for such alterations. Both primary and secondary biochemical and physiological changes are of interest. Obviously it may be extremely difficult to distinguish between cause and effect. If one assumes that most mental disease has purely psychic etiological factors, it still follows that they will probably produce secondary physiological abnormalities; the psychosomatic literature provides many examples (40). The reverse is equally true; somatopsychic phenomena are well known. Physiological and biochemical alterations profoundly influence mental functions, as evidenced by the effects of hypoxia, hypoglycemia, and hypercapnia, and by such drugs as the hallucinogens LSD-25 and mescaline. Drug therapy, if rational, need not affect only primary physiochemical alterations, but may give symptomatic relief by modifying secondary disturbances. For example, an agent like amphetamine does not correct the primary psychopathology involving neurotic obesity but does curb the secondary increase in appetite.All physiological and biochemical changes in psychoses, if real, are of interest to the pharmacologist, for drugs might be designed that can affect either primary or secondary metabolic or physiologic disturbances. Presumably our present tranquilizers act to reduce secondary physiologic disturbances in the overreactive, vociferous, and hallucinating patient but do not affect his primary psychopathology.In 1895, Maudsley (132) wrote on insanity with excitement that: "The many diligent and elaborate chemical analyses of the urine which have been made by different inquirers in different countries, notwithstanding that the tabular exposition of them might fill a large volume, have failed to yield definite and constant results or to warrant any positive inference." This statement is equally true today for all types of insanity, but perhaps it should be qualified. Thus, in 1957, we can paraphrase Maudsley's remarks of 62 years ago and say t...

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Section: Carbohydrate Metabolismmentioning

confidence: 99%

Biochemical and Physiological Changes Associated with Schizophrenia.

Domino¹

1959

Psychopharmacology: Problems in Evaluation.

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Glucose Tolerance in Chronic Schizophrenia and Senile States

Simon¹,

Garvey²

1951

Arch NeurPsych

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ABNORMAL glucose tolerance, characterized by a reduction of the tolerance to ingested sugar, has been reported in various mental disorders by a number of investigators. Diabetic-like blood sugar curves of a sustained type have been found in cases of schizophrenia, indicating a biochemical disturbance of the carbohydrate metabolism in this condition. Meduna and Vaichulis 1 reported diabetic-like reaction to the Exton-Rose glucose tolerance test in about 60 per cent of unselected schizophrenic patients. In a previous study, Meduna, Gerty and Urse 2 demonstrated a delay in the return of the blood sugar to a normal level following infusion of a dextrose solution in all of their 20 untreated schizophrenic patients. They concluded that a disturbance of the carbohydrate metabolism existed, as indicated by a delayed utilization of blood sugar, and postulated that this disturbance might be one of the etiologic factors in schizophrenia. However, Meduna, Braceland and Vaichulis 3 reported that the same type of abnormal curve can be obtained in the depressed and manic phases of manic-depressive psychosis and theorized that the same pathologic disturbance could be of etiologic significance in both schizophrenia and manicdepressive psychosis. Freeman, Rodnick, Shakow and Lebeaux * studied the carbo¬ hydrate tolerance of mentally disturbed soldiers and reported a reduction in glucose tolerance in two thirds, the dysfunction occurring not only in patients with schizo¬ phrenia but also in patients with nonpsychotic mental disturbances. They presented the hypothesis that reduced glucose tolerance is somehow related to emotional ten-

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The Rapid Intravenous Glucose Tolerance Test in Psychiatric Patients

Rames¹,

Simon²

1955

Arch NeurPsych

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A number of reports have appeared in the literature describing abnormal glucose tolerance in various mental disorders as measured by reduction in tolerance for ingested sugar. Carbohydrate metabolism is extremely complex and is interrelated with the fat and protein metabolism as well as with mineral metabolism. The measurement of one particular phase of carbohydrate metabolism by observation of the manner in which the organism utilizes a given amount of sugar gives rise to speculation that changes are occurring throughout the body, both within the cells and in the extracellular fluids, influencing all the metabolic processes in a chain reaction type of circuits and cycles. To date, no means of measuring total metabolism has been devised, and we must content ourselves with the piecemeal type of approach, subject to our limited techniques, and attempt to draw workable conclusions.The relationship between carbohydrate metabolism and mental illness became apparent first in 1928, when Manfred Sakel observed that long periods of insulin-induced hypoglycemia influenced mental symptoms. The exact nature of these changes is not known, but it is established that glucose is the only source of metabolic fuel utilized by the cells of the central nervous system, and alterations in its availability may act as a

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Significance of Insulin Inhibition by Blood of Schizophrenic Patients

Cited by 7 publications

References 11 publications

Biochemical and Physiological Changes Associated with Schizophrenia.

Biochemical and Physiological Changes Associated with Schizophrenia.

Glucose Tolerance in Chronic Schizophrenia and Senile States

The Rapid Intravenous Glucose Tolerance Test in Psychiatric Patients

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