Despite succinylcholine being the preferred ECT muscle relaxant, other nondepolarizing agents such as atracuronium, cisatracuronium, pancuronium, rocuronium, and vecuronium can be used (2). Rocuronium has the fastest onset of action and a relatively brief recovery of twitch response following reversal (4). In a recent small study of thirteen patients, a rocuronium dose of 0.3 mg/kg was used in a cross-over design with succinylcholine (4). Rocuronium is a nondepolarizing muscle relaxant with an action onset time of 1–2 minutes, although time to peak action tends to be longer. The dose of rocuronium in this study was lower than that typically used for rapid sequence induction (0.6 mg/kg), and it was reversed with neostigmine (20 μg/kg) and atropine (10 μg/kg). The study found that the time before the first spontaneous breath was significantly longer in the rocuronium group compared with the succinylcholine group (9.46 minutes and 8.07 minutes, respectively, p=0.02). Otherwise, rocuronium was found to be a safe alternative to succinylcholine with no significant hemodynamic differences.