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László Meduna's Pilot Studies With Camphor Inductions of Seizures: The First 11 Patients

Gazdag, Gábor MD, PhD*; Bitter, István MD, PhD, DSc†; Ungvari, Gabor S. MD, PhD‡; Baran, Brigitta MD†; Fink, Max MD§

doi: 10.1097/YCT.0b013e31819359fc
Original Studies

In his autobiography, László Meduna described the first session of convulsive therapy using intramuscular camphor as occuring on January 23, 1934 at Royal National Hungarian Institute of Psychiatric and Neurology at Budapest-Lipótmező in Hungary. Unearthed records of the patients treated at this institution reveal that Meduna's dose-finding experiments began on January 2, 1934. The symptomatology and history of illness, diagnosis, socio-demographic data, the seizure characteristics, and immediate and long term outcomes of the first 11 patients are described. These first trials elicited seizures in less than half the injections. Seizures of various durations (including missed seizures) and double (tardive) seizures were recorded. Mutism, refusal to eat requiring tube feeding, and other signs of catatonia dominated the psychopathology of 7 of the first 11 patients. Two improved sufficiently to be discharged from the hospital and third patient became fit for occupational therapy. These records exhibit the meticolous systematic nature of the first human trials with induced seizures and the fortuitous nature of the first human trials with induced seizures and the fortuitous nature in patient selection of catatonic patients - an illness that is most responsive to induced seizures.

From the *1st Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc Hospital, Budapest; †Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary; ‡Department of Psychiatry, Shatin Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China; and §Departments of Psychiatry and Neurology, Stony Brook University, Stony Brook, NY.

Received for publication September 22, 2008; accepted September 23, 2008.

Reprints: Gábor Gazdag, MD, PhD, 1st Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc Hospital, Koves utca., 1201 Budapest, Hungary (e-mail: gazdag@lamb.hu).

© 2009 Lippincott Williams & Wilkins, Inc.