Shridhar Sharma’s Reply to Donald F Klein Comments

Shridhar Sharma: Insulin Coma Treatment: Facts and Controversies

            I am thankful to Donald F. Klein for his comments.

            I agree that clinical trials have been negative, but careful observations in any research play an important role. We can learn from the Thaladomide tragedy. The same drug is now effectively used in Cancer Patients because today we have a better understanding of the mechanism of action of this drug.

            There is evidence on the relationship between negative symptoms of Schizophrenia and Plasma level of Insulin like growth factor I (IGFI) and the faulty modulation of dopaminergic neurotransmission (Palomino<s> A</s> et. al., 2013). Further, it is also suggested that IGFI could have a role in the Patho-physiology of negative symptoms. As mentioned by me earlier, there is also evidence for a negative association between Schizophrenia and Polymorphism in the Insulin receptor Substrate 3 (IRS-3) gene suggesting that individuals carrying the A allele of this A/G SNP in the IRS.3 gene, as well as estimated halotype 5 or 3X including this allele, may offer protection against the development of Schizophrenia (Melkersson and Person , 2012).

            I have given further evidence in my earlier reply to Hector Warnes Comments which I hope Dnald F. Klein would like to see.



Melkersson K, Persson B. Evidence for a negative association between schizophrenia and a polymorphism in the insulin receptor substrate-3 (IRS-3) gene. Neuro Endocrinol Lett. 2012; 33:321-30.

Palomino A, González-Pinto A, Martinez-Cengotitabengoa M, Ruiz de Azua S, Alberich S, Mosquera F, Matute C. Relationship between negative symptoms and plasma levels of insulin-like growth factor 1 in first-episode schizophrenia and bipolar disorder patients. Prog Neuropsychopharmacol Biol Psychiatry. 2013; 44: 29-33.


October 26, 2017