Sulfozinum

Colloidal sulphur, better known as the brand name Sulfosin or one of its spelling variants (sulfazin, sulfozin, sulfozine, sulfozinum), is a pharmaceutical drug originally used for its ability to causes a pyrogenic reaction (body temperature elevation).[1][2] Sulfosin is a 0.37 – 2% sterilized solution of purified elemental sulfur in peach oil or olive oil for intramuscular injections. The preparation is unstable, so it was prepared only in local hospital pharmacies. The intramuscular injection causes a muscle necrosis, fever, immobility, and severe pain.[3][4]

Sulfosin was introduced to medical use by Danish physician Knud Schroeder in February 1924. It was used for both neurosyphilis "insanity" and psychiatric "instanity", the latter being inspired by the success of pyrotherapy against neurosyphilis. It was modestly effective for the former, but its effectiveness in non-syphilitic/functional psychoses was far less pronounced: in the most hopeful interpretation, it appeared largely ineffective for schizophrenia, completely ineffective for epilepsy, but slightly effective for manic depression. Nevertheless, it was considered useful in comparison to the other available options.[5] As a result it saw considerable use in many parts of the world (especially in Spain), but was phased out when penicillin and shock therapy became available.[5] The Soviet Union, however, consinued to use it for various psychiatric conditions (including politically-motivated diagnoses),[6][7] and alcoholism.[8] It was not used in American psychiatry.[4]

In medical applications, a number of improvements aimed to reduce the pain associated with Sulfosin: the injection volume was decreased using the more concentrated 2% strength and a topical anesthetic is typically given before hand. There are also compound medications that combined Sulfosin with a topical anesthetic such as benzocaine (Neosulfosin and Anaesthesulf).[5]

Soviet Union

The Soviet Union did not phase out Sulfosin when other parts of the world did. Nevertheless, they did adopt the use of anesthetic before injection when the drug is not used for disciplinary or repressive reasons, specifically 0.5-2 mL of 2% novocaine.[5]

The American delegation during its visit to the USSR in 1989 confirmed charges of the use of Sulfosin injections.[9] Psychiatrists in the USSR employed Sulfosin treatment allegedly to increase treatment response to neuroleptic administration but were unable to present any research evidence of its efficiency for this purpose.[3] The painful effects caused by sulfozine, as well as the pattern of its use in 10 persons, suggest that the medication was applied for punitive rather than therapeutic purposes.[3]

Real benefits of its use in psychiatry are disputable, but it was widely used due to its extremely painful action, lasting from several hours to 2–3 days, as a punishment for psychiatric patients and in political abuse of psychiatry.[10] Sulfozine symbolised Soviet punitive psychiatry.[11]

In 1989, during Perestroika, its use was restricted only to cases when its prescription was confirmed both by consilium and by informed consent of the patient or his representatives.[12] Its present use is not known.

In post-Soviet Russia

Some psychiatrists in post-Soviet Russia call the criticism of Sulfosin "attacks on psychiatry" and still believe that Sulfosin was sometimes the only effective treatment when all other ones were ineffective in calming down violent patients.[13] The psychiatrists say that Sulfosin really brought a psychosis to remission.[13]

See also

References

  1. ^ Malkina, MG; Martynov, LA (1958). "Stimulation of pyrogenic effect of sulfozine". Farmakologiia i Toksikologiia. 21 (3): 47–9. PMID 13562185.
  2. ^ Zaltsman GI, Lunskii GP (1961). "Effect of aminazin on hyperthermia produced with sulfozin". Izvestiia. Seriia Fiziologii i Meditsiny Qazaq SSR Ghylym Akademiiasy. 2 (2): 96–100. PMID 24547024.
  3. ^ a b c "Report of the U.S. Delegation to Assess Recent Changes in Soviet Psychiatry" (PDF). Schizophrenia Bulletin. 15 (4 Suppl): 3. 1989. doi:10.1093/schbul/15.suppl_1.1. PMID 2638045. Retrieved 20 February 2014.
  4. ^ a b Probes, Lawrence; Kouznetsov, Vladimir; Verbitski, Vladimir; Molodyi, Vadim (June 1992). "Trends in Soviet and Post-Soviet Psychiatry" (PDF). The PSR Quarterly. 2 (2): 67–76. ISSN 1051-2438.
  5. ^ a b c d Igual, M. Marco (2021). "Sulfosin, a centennial drug between therapy and punishment". Neurosciences and History. 9 (2): 55–68.
  6. ^ Antropov, IuF (1981). "Various methods of overcoming resistance to therapy in childhood and adolescent schizophrenia". Zhurnal Nevropatologii i Psikhiatrii Imeni S.S. Korsakova. 81 (10): 1522–6. PMID 6118983.
  7. ^ Dochkov, Zh (1959). "Sulfozin therapy of certain psychoses". Suvremenna Meditsina. 10 (1): 81–8. PMID 13668869.
  8. ^ Kalabukha, AV; Kalabukha, VA (1981). "Use of sulfozine to treat chronic alcoholism in pulmonary tuberculosis". Problemy Tuberkuleza (3): 38–41. PMID 7232391.
  9. ^ Moran, Mark (5 November 2010). "Psychiatric abuses once led to Cold War confrontation". Psychiatric News. 45 (21): 6. doi:10.1176/pn.45.21.psychnews_45_21_009.
  10. ^ Korotenko A.I.; Alinkina N.V. (2002). Soviet Psychiatry : delusions and intentions (in Russian). Kyiv: Sfera. p. 60. ISBN 9667841367.
  11. ^ Amnesty International French Medical Commission and Valérie Marange (1991). Doctors and torture: resistance or collaboration?. Bellew Pub. p. 64. ISBN 0947792562.
  12. ^ Приказ Минздрава СССР от 15.08.1989 № 470 — Russian DoH order (in Russian)
  13. ^ a b Malyavin, Maxim (13 July 2012). "Extreme psychiatry" (in Russian). ABC magazine.
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