All patients presented with major depression disorder not received ECT previously within 6 monthes, admitted to the study site ( Psychiatry department, in Assiut University Hospital, Assiut, Egypt). They Fulifilled will be recruited within 6 monthes duration .

The patients classified into group A comprised that will be treated with Unipolar ECT, and group B comprised that will be treated Biploar ECT.

Electroconvulsive therapy was administered by using bidirectional constant current, brief-pulse devices. During the procedure, the patients were sedated using propofol or thiopenthal. Succinylcholine (1 mg/kg) was used as muscle relaxant, and glycopyrrolate (0.2 mg) or atropine was used as an anticholinergic agent when necessary. The mean charges were 351 (SD, 143) mC for the unilateral electrode placement group, 417 (SD, 192) mC for the bitemporal electrode placement group and 260 (SD, 76) mC for the bifrontal electrode placement group, (Brus, Ole MSc, 2017).

The average course of treatment for depression is 6 to 12 treatments, but some patients may require as many as 20 treatments,

Reach the least level of side effects in memory of Recent treatment with ECT in patient with major depression.

measurement tool: _ History taking and full general & neurological examination to exclude any neurological disease.

• Minim Mental State Examination, (MMSE) (Appendix I)

• All Scales will be taken at date of admission, and at discharge up to 15 days and after three months of discharge .

  • All patients will be subjected to full psychiatric history and examination. The results of the above mentioned laboratory, investigations will be included in future analysis and interpretation of patients' abnormal psychiatric findings.

• Hamiliton rate Scale for depression,(HAM-D) (Appendix II),before and after treatment with ECT.
• All Scales will be taken at date of admission,and at discharge up to 15 days and after three months of discharge .

Memory scale (MONTREAL COGNITIVE ASSESSMENT. MOCA), (Appendix III) All Scales will be taken at date of admission,and at discharge up to 15 days and after three months of discharge .