Acetaminophen Preferable to Ibuprofen for Pretreatment of Electroconvulsive Therapy-Induced Headache

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Sir: It is curious that Leung and colleagues¹ would promote first-line use of a nonsteroidal anti-inflammatory drug (NSAID), albeit the least problematic one, for pretreatment of electroconvulsive therapy (ECT)-induced headache. It is recommended that ibuprofen be given with food or milk, but pre-ECT medication must be given on an empty stomach, with a sip of water. The gastrointestinal complications of NSAID treatment are well documented.²