Yeah, we've tried all the recommended medicinal options (the ones listed in the protocol used by the doctors) before my Pdoc recommended me for ECT. I think I'll take a copy of the protocol with me when I next talk to the ECT people so that I can prove that. The two Pdocs that know me well have both given me referrals (the second one after the first referral bounced), so it's not like I'm going to hospitals out of the blue or something, and it's not like I haven't given this a lot of thought. The old attitude that ECT should be a last resort is also supposed to be changing, at least that's what I read everywhere, but I haven't noticed that personally yet. IMHO (and that's also what the protocol says) patient preference should be a big factor as well. It's my head after all. Like I said, I've gone through all the steps in the protocol they use, but there are always more meds or combinations of meds to try, so at some point it'll always come down to patient preference.

That said, it's good to hear that bupropion may be a good option if the ECT doesn't work out. I guess it's supposed to be less likely to worsen mixed features. What dosage are you at? As far as I know there's no established recommended dosage, but I'll probably start low and work my way up if I try it, given that I'm pretty sensitive to meds.