We describe an individual with psychotic depression and bulimia who demonstrated spontaneous post-electroconvulsive therapy (ECT) myoclonic jerks after her fifth unilateral treatment. After switching to bilateral ECT, the patient developed generalized tonic-clonic seizures, beginning about 2 min after each treatment and lasting for about 4 min. These were confirmed by electroencephalographic (EEG) recording, and could be terminated and also effectively prevented by intravenous midazolam. Differential diagnosis, risk factors, and management are discussed.