[Treatment of postictal (emergence) delirium after electroconvulsive therapy]

Most patients treated with electroconvulsive therapy (ECT) develop cognitive and motor aspects of delirium afterwards. These symptoms are often self-limiting, lasting 10 to 20 minutes. However, about 10% of these patients develop a state characterised by confusion, restlesness, repetitive movements, lack of response to commands and amnesia regarding the period. This state, called emergence delirium, usually has a short duration but may persist for hours. In the present case a 50-year-old woman had 18 ECT treatments for severe depression. She experienced excellent effects as regards the depressive symptoms, but postictally she developed all the above-mentioned symptoms of delirium, which lasted for several hours. The ECT continued, and the patient was successfully treated for the condition with administration of i.v. diazepam (5 mg) shortly after the end of each seizure.