The purpose of the study is to examine the effect of bupropion on seizure threshold and duration in depressed patients receiving right unilateral ultra-brief electroconvulsive therapy (ECT). The investigators plan to recruit 10 patients into the study, administer sustained release (SR) bupropion 4 hours prior to receiving ECT. The investigators plan to compare the seizure threshold and seizure durations between ECT sessions with and without bupropion administration. The study's implication is to examine how ECT can be optimized by rational combination with medications that lower seizure threshold.

Background and significance Depression is the leading cause of disability in individuals aged 15-44, resulting in 400 million disability days in a year (1). The total economic burden of the disease is estimated to be composed of $26.1 billion in direct medical costs, $5.4 billion in suicide-related mortality costs, and $51.5 billion in indirect workplace cost (1). Electroconvulsive therapy (ECT) is the gold-standard treatment for major depressive disorder (MDD) that is severe (2-5). The standard method of ECT used in the US now is right unilateral ultra-brief study. RUL ECT uses a pulse width of \

Inclusion Criteria:

1. Male and female subjects, age >18.
2. Meeting diagnostic criteria for major depressive disorder or bipolar disorder per DSM5.
3. Referred for ultra brief RUL ECT.
4. Right motor dominant.
5. Competent to provide informed consent.
6. Able to read or comprehend English.
7. H/O treatment with bupropion.
8. Concomitant treatment with benzodiazepines, dosing of which has remained stable for a week prior to study ECT session.

Exclusion Criteria:

1. Lifetime history of schizophrenia, schizoaffective disorder, mental retardation, seizure disorder.
2. Current alcohol abuse or dependence within past 6 months.
3. Current substance abuse or dependence within past 6 months.
4. Recently received ECT within preceding 3-6 months.
5. Currently on any formulation of bupropion.
6. Currently on any anticonvulsants or clozapine.

Adverse events were assessed on days 1 and 2 of treatment and for a week after treatment 2.

Blinding to be done - Outcome assessor and care provider will be blinded to randomization arm of subject