Am J Psychiatry 1987; 144:1143-1148
Copyright © 1987 by American Psychiatric Association
Use of caffeine to lengthen seizures in ECT
PE Hinkle, CE Coffey, RD Weiner, M Cress and C Christison
During a course of ECT, seizure duration may become too brief for clinical
benefit. Use of higher-energy stimuli may lengthen seizures but may also
increase the risk of toxicity, and it is not possible when maximum settings
are reached. The authors present the cases of six drug- free depressed
inpatients whose seizure durations in ECT declined despite maximum settings
on three different ECT devices. In all cases, pretreatment with caffeine
lengthened seizures (mean increase = 107%), and clinical improvement
followed. Caffeine was well tolerated, even in patients with cardiovascular
diseases.
