Post-procedure myalgia is a well-known and common complication of ECT. Although the exact etiology is unknown, the myalgias are believed to result from a combination of succinylcholine administration and the seizure activity induced by the ECT procedure itself. Succinylcholine-induced postoperative myalgias are a well-known phenomenon, initially described in the early 1950's. The exact pathogenesis is unknown, with muscle damage from succinylcholine-induced fasciculations or calcium-mediated phospholipase A2 activation and prostaglandin production being proposed as possible etiologies. The latter mechanism provides the rationale for using NSAID therapy. However, succinylcholine is unlikely to be the only factor involved in the development of myalgias following ECT, as a recent study showed that dose adjustments to succinylcholine did not affect rates of myalgia in these patients. Furthermore, seizures can also cause direct muscle injury and there have been reports of muscle pain after ECT both with and without succinylcholine.