Editor , The American Journal of Psychiatry.
Abstract
CHIATRY.PSY-as a footnote in the article entitled âAlcoholism, Neurosyphilis, Shock Therapy and Geriatrics,â under 1941 Review of Psychiatric Progress, Vol. 98:591, January, 1942: âCurare, erythroidine or similar substances should not be used with electroshock for the prevention of fractures as the degree of respiratory failure is much greater than when metrazol shock is used.â Such a statement is inaccurate and will be responsible for unnecessary traumatic fracture complications to patients. The authors either have had little experience with curare-electroshock therapy or are unaware of the pharmacology of curare action. Curare has no other action than a peripheral neuromuscular block. There is no central action whatever. Therefore,no increased respiratory embarrassmentof spine or extremities. The fundamental problem is the severity of the convulsion which can only be relieved by softening the seizure through the principle of curarization. On page 534 of this same issue, authors H. Worthing and L. B. Kalinowsky admit they have not used curare but state incorrectly that it causes respiratory embarrassment. They felt they did not dare add to central electric effect of depressed respiration, a peripheral impairment of respiratoryJ.curare.Because of the importance of this problem in shock therapy in order that the curare modification may