Caffeine augmentation in electroconvulsive therapy

Introduction Electroconvulsive therapy (ECT) is considered the most effective treatment in psychiatry, with particular efficacy in the major psychoses. However, seizure threshold progressively rises during the course of ECT indicated by reduced seizure quality and length. Therefore, the applied charge is increased. However, charge is linked to cognitive side effects and therapists strive for lowest possible charge evoking a sufficient seizure. Proconvulsive augmentation using caffeine can prolong seizure length but might also evoke cardiac dysrhythmias.