{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T06:14:40Z","timestamp":1768544080094,"version":"3.49.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacopsychiatry"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective Studies have demonstrated the efficacy of injectable caffeine as\n                    an augmentation method in electroconvulsive therapy (ECT). This study\n                    investigated whether orally administered caffeine increases seizure duration\n                    during ECT.<\/jats:p><jats:p>\n          Methods Medical records of 40 patients treated with a series of ECT were\n                    retrospectively analyzed. Patients whose electroencephalogram (EEG) seizure\n                    duration had dropped&lt;30\u2009s, or motor seizure\n                    duration&lt;15\u2009s were included. They subsequently received oral\n                    caffeine (0.2\u2009g) before ECT sessions. Primary outcomes were EEG seizure\n                    duration and motor seizure duration, compared with those from the last\n                    pre-caffeine session (baseline) and the first five caffeine-augmented sessions.\n                    The mental state was assessed with the Global Assessment of Functioning (GAF).\n                    In addition, data on maximum heart rate, maximal arterial pressure, and adverse\n                    effects were collected.<\/jats:p><jats:p>\n          Results The EEG seizure duration increased by 14.9\u2009s (52%)\n                    on average between baseline and the first caffeine-augmented session. The\n                    increased length remained widely stable over the subsequent ECT sessions. EEG\n                    seizure duration was&gt;30\u2009s in more than 80% of sessions.\n                    A statistically significant increase in motor seizure duration appeared only in\n                    the 2nd and 3rd of five sessions with augmentation. Oral\n                    caffeine pretreatment was overall well tolerated. The percentage of patients\n                    with at least serious mental impairment (GAF score\u226450) dropped from 77.5\n                    to 15%.<\/jats:p><jats:p>\n          Conclusions Results suggest the utility of oral caffeine (0.2\u2009g)\n                    to increase ECT-induced seizures in patients with durations below clinically\n                    significant thresholds.<\/jats:p>","DOI":"10.1055\/a-2197-9635","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T23:48:05Z","timestamp":1700783285000},"page":"30-34","source":"Crossref","is-referenced-by-count":2,"title":["Augmentation of Electroconvulsive Therapy with Oral Caffeine: A\n                    Retrospective Analysis of 40 Patients with Major Depression"],"prefix":"10.1055","volume":"57","author":[{"given":"Peter","family":"Nyhuis","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Psychiatrie, Psychotherapie und Psychosomatik, St.\n                    Marien Hospital Eickel, Herne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothea","family":"M\u00fccke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Psychiatrie, Psychotherapie und Psychosomatik, St.\n                    Marien Hospital Eickel, Herne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Specka","sequence":"additional","affiliation":[{"name":"LVR-University Hospital Essen, Department of Psychiatry and\n                    Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Scherbaum","sequence":"additional","affiliation":[{"name":"LVR-University Hospital Essen, Department of Psychiatry and\n                    Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.psc.2018.04.001","article-title":"Electroconvulsive therapy in depression. Current practice and future\n                    direction","volume":"41","author":"A P Hermida","year":"2018","journal-title":"Psychiatr Clin North Am"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1017\/neu.2018.32","article-title":"ECT in schizophrenia: A review of the evidence","volume":"31","author":"S Grover","year":"2019","journal-title":"Acta Neuropsychiatr"},{"key":"ref3","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511576393","volume-title":"Electroconvulsive and neuromodulation therapies","author":"C M Schwartz","year":"2009"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.3389\/fpsyg.2020.00080","article-title":"Effects on electroconvulsive therapy on depression and its potential\n                    mechanism","volume":"11","author":"M Li","year":"2020","journal-title":"Front Psychol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/YCT.0000000000000503","article-title":"Caffeine sodium benzoate for electroconvulsive therapy augmentation","volume":"34","author":"K M Bozymski","year":"2018","journal-title":"J ECT"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.2147\/NDT.S134503","article-title":"Effects of stimulus parameters on motor seizure duration in electroconvulsive\n                    therapy","volume":"13","author":"W J Sung","year":"2017","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/j.brs.2021.05.016","article-title":"Changes in seizure duration during acute course electroconvulsive therapy","volume":"14","author":"J Luccarelli","journal-title":"Brain Stimul"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1097\/00124509-200209000-00002","article-title":"Augmentation of seizure induction in electroconvulsive therapy: A clinical\n                    reappraisal","volume":"18","author":"C Datto","year":"2002","journal-title":"J ECT"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1097\/YCT.0b013e3181e48143","article-title":"Augmentation strategies in electroconvulsive therapy","volume":"26","author":"C Loo","year":"2010","journal-title":"J ECT"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1007\/s00018-003-3269-3","article-title":"Caffeine as a psychomotor stimulant: Mechanism of action","volume":"61","author":"G Fisone","year":"2004","journal-title":"Cell Mol Life Sci"},{"key":"ref11","volume-title":"Drogen und psychopharmaka, Bd 1 [Recreational and medical psychotropic\n                    drugs]","author":"R Julien","year":"1997"},{"key":"ref12","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-662-49564-3","volume-title":"Koffein. Caffeine","author":"W Beiglb\u00f6ck","year":"2016"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1176\/ajp.150.10.1543","article-title":"A reappraisal of the role of caffeine in ECT","volume":"150","author":"W V McCall","year":"1993","journal-title":"Am J Psychiatry"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1176\/ajp.147.5.579","article-title":"Caffeine augmentation of ECT","volume":"147","author":"C E Coffey","year":"1990","journal-title":"Am J Psychiatry"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1176\/ajp.144.9.1199","article-title":"Facilitation of ECT by caffeine pretreatment","volume":"144","author":"B Shapira","year":"1987","journal-title":"Am J Psychiatry"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1177\/0897190014549838","article-title":"Pretreatment with caffeine citrate to increase seizure duration during\n                    electroconvulsive therapy: A case series","volume":"29","author":"A Pinkhasov","year":"2016","journal-title":"J Pharm Pract"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1176\/ajp.149.1.137","article-title":"Oral caffeine augmentation of ECT","volume":"149","author":"R Ancill","year":"1992","journal-title":"Am J Psychiatry"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/00124509-200203000-00002","article-title":"Stimulus titration and ECT dosing","volume":"18","author":"R Abrams","year":"2002","journal-title":"J ECT"},{"key":"ref19","first-page":"597","article-title":"Electroconvulsive therapy at the Department of Psychiatry and Psychotherapy,\n                    University of Munich. Development during the years 1995-2002","volume":"76","author":"T C Baghai","year":"2005","journal-title":"Nervenarzt"},{"key":"ref20","first-page":"672","article-title":"Factors affecting electroconvulsive therapy ictal outcomes: Duration and\n                    postictal suppression","volume":"6","author":"W M Ingram","year":"2019","journal-title":"AMIA Jt Summits Transl Sci Proc"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/1744-859X-10-2","article-title":"Guidelines for rating Global Assessment of Functioning (GAF)","volume":"10","author":"I H Aas","year":"2011","journal-title":"Ann Gen Psychiatry"},{"key":"ref22","first-page":"65","article-title":"A simple sequentially rejective multiple test procedure","volume":"6","author":"S Holm","year":"1979","journal-title":"Scand J Statist"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1176\/ajp.144.9.1143","article-title":"Use of caffeine to lengthen seizures in ECT","volume":"144","author":"P E Hinkle","year":"1987","journal-title":"Am J Psychiatry"},{"key":"ref24","first-page":"95","article-title":"Caffeine pretreatment enhances clinical efficacy and reduces cognitive effects\n                    of electroconvulsive therapy","volume":"9","author":"A Calev","year":"1993","journal-title":"Convuls Ther"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/089198879500800305","article-title":"Safety and efficacy of caffeine-augmented ECT in elderly depressives: A\n                    retrospective study","volume":"8","author":"M Kelsey","year":"1995","journal-title":"J Geriatr Psychiatry Neurol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/00124509-200106000-00004","article-title":"Inverse relation between stimulus intensity and seizure duration: Implications\n                    for the ECT procedure","volume":"17","author":"R Frey","year":"2001","journal-title":"J ECT"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"166","DOI":"10.3389\/fpsyt.2013.00166","article-title":"The clonic phase of seizures in patients treated with electroconvulsive therapy\n                    is related to age and stimulus intensity","volume":"4","author":"C C Wang","year":"2013","journal-title":"Front Psychiatry"}],"container-title":["Pharmacopsychiatry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2197-9635.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T14:31:13Z","timestamp":1730817073000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2197-9635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,23]]},"references-count":27,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2024,1,9]]},"published-print":{"date-parts":[[2024,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2197-9635","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0176-3679","1439-0795"],"issn-type":[{"value":"0176-3679","type":"print"},{"value":"1439-0795","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,23]]}}}