Aminophylline increases seizure length during electroconvulsive therapy

Electroconvulsive therapy (ECT) is considered to be one of the most effecti ve treatments for patients with major depression and persistent psychosis. Seizure characteristics probably determine the therapeutic effect of ECT; a s a consequence, short seizures are accepted as one of the factors of poor outcome. During most ECT courses seizure threshold increases and seizure du ration decreases. Methylxanthine preparations, caffeine, and theophylline h ave been used to prolong seizure duration. The use of aminophylline, more r eadily available than caffeine, has not been well documented. The objective of this study was to test the effects of aminophylline on seizure length. Fourteen drug-free patients with diagnoses of affective disorder or psychot ic episode receiving ECT participated in this study. Seizure length was ass essed clinically and per EEG. Statistical comparisons were done using paire d t tests. A significant increase (p < 0.04) in seizure length was achieved and maintained on three subsequent treatments with aminophylline. No adver se events were noted from the addition of aminophylline.