I have severe anxiety and insomnia and was very reluctant to try bupropion for those reasons. Well, I finally tried it (after years of resisting) and thus far, I am delighted with it. It has not worsened my anxiety, it does not cause insomnia, and I am finding it to be an excellent anti-depressant. My pdoc started me out on a low dose (sub-clinical) and we've worked up to the clinical dose after about a month. Of course, Wellbutrin doesn't work for everyone, but it sure does seem to be one of the most successful meds, overall.
I do want to mention that Lamotrigine has no especially detrimental effect on the kidneys. It's not like lithium.
I don't know where you are located, FluffyD, but I do know that where I am, and from what I've been told, no one is approved for ECT until all medicinal options have been given a good try.