Herrman NWC, et al. - In the emergency department (ED), presentation with bupropion overdose is frequent. While supportive care leads to a resolution in the majority of cases, serious adverse effects, comprising seizures, cardiogenic shock, and death, can occur. For a variety of different overdose situations, promising effects are noted with intravenous lipid emulsion (ILE) therapy, however, for cases of bupropion poisoning, it has traditionally been utilized as a last-line rescue modality. Here the researchers report the case of a young woman who presented to the ED with altered mental status complicated by seizure following bupropion overdose. In this case, vasopressor support was provided for the subsequent development of cardiogenic shock. A reduced left ventricular ejection fraction (LVEF) was noted in the bedside echocardiogram. Intravenous lipid emulsion (ILE) therapy led to significant improvement in both hemodynamic status and LVEF by bedside ultrasound. This case emphasizes that consideration should be given to early initiation of ILE therapy in these cases based on hemodynamic parameters and bedside ultrasound, as the potential benefits likely outweigh the theoretical risks.