A thorough literature search using Medline, Ovid, and scholar.google failed to find any research articles evaluating pretreatment therapy for myalgias in post-ECT patients. The current practice for the treatment of myalgias following ECT has been extrapolated from research on succinylcholine-induced myalgia in post-surgical patients. Previous studies have shown at least partial efficacy with pretreatment of nondepolarizing neuromuscular blocking agents, benzodiazepines, sodium channel blockers (predominantly lidocaine), and nonsteroidal anti-inflammatory drugs. The nature of the ECT procedure itself makes several of these modalities undesirable. Both Lidocaine and benzodiazepines can alter the seizure threshold and the short duration of the procedure possibly increases the risks associated with longer acting nondepolarizing muscle relaxants (ie. blurred vision, diplopia, difficulty breathing and swallowing). Therefore, the options for pretreatment are limited. In addition, a recent meta-analysis of randomized trials determined NSAIDs to cumulatively have the best efficacy of any pretreatment therapy in the prevention of post-procedural myalgias. Due to its intravenous formulation, some practitioners have administered ketorolac to ECT patients before the procedure. However, despite a proven efficacy in myalgia prevention shown by NSAIDs as a class, a study specifically examining the use of ketorolac in this regard failed to show any benefit. The use of Ibuprofen has yet to be examined.