Post-electroconvulsive therapy (ECT) delirium is commonly encountered in practice, occurring in up to 12% of treatments. Although often easily managed nonpharmacologically, more severe or persistent cases are generally treated with benzodiazepines or propofol. We describe a patient who failed to respond adequately to these medications but responded quite favorably to dexmedetomidine, a centrally acting α2 agonist. There is evidence that dexmedetomidine may have unique, "delirium-sparing" properties; this makes it an attractive option for this indication.
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Cohen et al. (2013) studied this question.