The Psychopathological effect of Sodium Amytal.

Abstract

Isoamylethylbarbiturate was introduced into psychiatry by Lorenz and Bleckwenn in 1929. It was recommended to produce profound sleep which in certain neuropsychiatric patients was followed by peculiar changes in behavior. Lucid intervals with good contact and almost complete insight were produced in certain cases of catatonic dementia precox. Depressed or excited patients had periods of calmness and contentment. In some cases, improvement, in others a rapid recovery followed the repeated induction of sodium amytal narcosis. We conducted experiments guided by the assumption that the striking changes following sodium amytal administration cannot be sufficiently explained on the basis of the narcosis produced. We studied the drug action, therefore, in very small doses not leading to any narcosis or sleep at all. In examining patients'responses as compared with the observations by the authors mentioned above we found that after the injection of less than half of the dose used by Bleckwenn, when no signs of narcosis could be observed, there nevertheless was a striking change in the patient's behavior similar to the change described as the result of narcosis. Theis led us to a more systematic investigation of the effect of sodium amytal, particularly since such small doses are void of all the disadvantages and dangers involved in any prolonged narcosis. It seemed indispensabel to study the effect of the same doses as used in psychotic patients with normal individuals. Sodium amytal crystals dissolved in distilled water to a 1 gr./1 cc. solution were injected intravenously. One grain was injected during the period of a minute. The injection was stopped as soon as the patient showed the first signs of psychological change. The administration of 3 to 4 1/2 grains was sufficient to produce the change which we wanted to study.