Bupropion overdose in the pediatric setting poses significant potential for toxicity. We present the case of a 15-year-old female patient presenting with intentional bupropion overdose resulting in generalized tonic-clonic seizures, severe acidosis, vomiting, and tachycardia after ingestion of between 1,650 to 9,000 mg (24-133 mg/kg) of bupropion. The patient was admitted to pediatric intensive care unit (PICU) where toxicity was resolved promptly following administration of intravenous lipid emulsion (ILE) infusion. ILE is a first-line treatment for other forms of toxicity including unintended local anesthetic administration. ILE use is not a first-line treatment in this setting, but this case presents a positive subsequent patient outcome.
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http://dx.doi.org/10.1055/s-0039-1693483 | DOI Listing |
Nephrology (Carlton)
January 2025
Excellence Centre for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Bupropion is used as smoking cessation drug and antidepressant. Drug overdose has multi-system involvement including neurotoxicity and cardiovascular collapse. Use of haemoperfusion in bupropion toxicity is generally not useful, however in life-threatening condition it could be a life saver.
View Article and Find Full Text PDFCureus
October 2024
Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, USA.
Bupropion is a norepinephrine-dopamine reuptake inhibitor that is commonly used as an antidepressant and for smoking cessation. Bupropion overdose can lead to serious side effects which include seizures, status epilepticus, and fatal arrhythmias. Managing bupropion toxicity is challenging as there is no effective antidote and treatment is largely supportive.
View Article and Find Full Text PDFClin Toxicol (Phila)
September 2024
American College of Medical Toxicology, Phoenix, AZ, USA.
Introduction: Tricyclic antidepressants often cause drug-induced QRS complex prolongation in overdose but are now less commonly prescribed. We sought to determine, among a contemporary cohort of patients, the pharmaceuticals independently associated with QRS complex prolongation in acute overdose.
Methods: We performed secondary analysis of data from the Toxicology Investigators Consortium (ToxIC) Core Registry.
Cureus
June 2024
Department of Pulmonary Critical Care, Legacy Emanuel Medical Center, Portland, USA.
Acad Emerg Med
November 2024
Center for Research on Emerging Substances, Poisoning, Overdose, and New Discoveries, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Objectives: Bupropion toxicity can lead to adverse cardiovascular events (ACVE), but delayed onset of toxicity makes risk stratification difficult. This study aimed to validate previously defined predictors of ACVE and identify novel predictors among patients presenting to the emergency department (ED) after bupropion overdose.
Methods: This secondary analysis of prospective data from the Toxicology Investigators Consortium Core Registry analyzed adult acute or acute-on-chronic bupropion exposures from 2015 to 2018.
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