The first of the mechanistic treatments  developed in the 1930s was Dr Manfred Sakel’s Insulin Coma Therapy. In 1927 Dr Sakel had been treating drug addicts with insulin injections at a psychiatric clinic in Berlin. One of his patients slipped into an unintended coma and on recovery, reported improved mental clarity and a reduced craving for drugs. Suspecting that insulin coma might be adapted to treat mental illness, Sakel began using the technique to treat patients in a Viennese clinic. He injected schizophrenics with insulin until their blood sugar levels dropped to the point where they lapsed into hypoglycaemic shock – comas that were sometimes accompanied by convulsions. The insulin injections were given on six days each week and courses of treatment could go on for two months with the unfortunate patients experiencing fifty or sixty comas. Intravenous glucose was given to bring them back from the brink of death. The treatment required specially trained staff who would monitor the patients constantly in dedicated insulin coma units.

Sakel later said he’d been researching and conducting animal experiments in preparation for his work on human subjects and it seems that there is some truth to this claim, but as Dr Kingsley Jones pointed out in ‘The Journal of The Royal Society of Medicine’ in March 2000, these experiments actually took place in Dr Sakel’s kitchen. As Sakel developed the treatment he began to publish results that showed astonishing improvements in his patient’s mental health, but which other psychiatrists couldn’t replicate. Insulin coma was a risky treatment and there were side effects up to and including brain damage and death. In 1954 Dr Eugene Revitch’s study ‘Observations on organic brain damage and clinical improvement following protracted insulin coma’, published in The Psychiatric Quarterly actually claimed that brain damage could be seen as an improvement in a patient’s condition because from then on, they showed less ‘tension and hostility.’