Bupropion abuse and overdose

Stall, Nathan M.; Godwin, Jesse; Juurlink, David N.

doi:10.1503/cmaj.131534

Cited by 40 publications

(25 citation statements)

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“…At approximately 3 hours after ingestion, bupropion reaches an effective plasma concentration and the elimination half-life is approximately 21 hours [1,12]. Bupropion maximum plasma concentration of around 140 g/L is reached approximately 3 hours after oral ingestion of 150 mg.…”

Section: Discussionmentioning

confidence: 99%

“…Bupropion poisoning discharged the next day. The most frequently seen side-effects of bupropion are insomnia (34%-42%), headache (26%) and mouth dryness (10%) [1,14]. Rashes, nausea, excessive sweating, tinnitus and hypertension (especially in patients with underlying hypertension) are also seen [15].…”

Section: Discussionmentioning

confidence: 99%

“…Bupropion is a selective reuptake inhibitor of noradrenaline, dopamine and serotonin [1,2]. Bupropion is currently used in the treatment of major depression and smoking cessation [3].…”

Section: Introductionmentioning

confidence: 99%

“…Bupropion was approved by the Food and Drug Administration (FDA) in 1997 for smoking cessation treatment, and was the first non-nicotine pharmacological agent [3]. Bupropion lowers the seizure threshold [1,4]. Therefore, bupropion can cause seizures at therapeutic doses.…”

Section: Introductionmentioning

confidence: 99%

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Successful management of bupropion poisoning: possible benefit of acidosis treatment

Altıntop

Tatlı

2017

The European Research Journal

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Bupropion is used as an antidepressant and smoking cessation aid. It has been described in the literature as a norepinephrine-dopamine reuptake inhibitor and is also a nicotinic antagonist. Bupropion itself is not a common cause of intoxication cases seen in Emergency Department (ED). The most important side effect is an increase in risk for epileptic seizures. We aimed to present the management of a 29-year-old female patient in ED with epileptic seizures and acidosis due to bupropion intoxication, who had taken 30 bupropion 150 mg tablets and 16 fluoxetine 20 mg tablets for suicidal purpose. According to her blood gas counts sodium bicarbonate therapy was begun in ED and after having response to the treatment was continued in intensive care unit. She was discharged three days later without any other seizures and complications. Although bupropion intoxication is rare it can cause severe metabolic acidosis and epileptic seizures. There is no specific antidote therapy to bupropion so symptomatic therapy still have benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Bupropion is a selective reuptake inhibitor of noradrenaline, dopamine and serotonin [1,2]. Bupropion is currently used in the treatment of major depression and smoking cessation [3].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Successful management of bupropion poisoning: possible benefit of acidosis treatment

Altıntop

Tatlı

2017

The European Research Journal

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“…Although originally considered unlikely [10,11], some recent reports of bupropion abuse, especially among young adults and adolescents, have been published. At present, ten peer-reviewed articles in which ''bupropion abuse'' is mentioned in the title of the article can be found in PubMed (accessed 11 December 2015) [10,[12][13][14][15][16][17][18][19][20]. Half of these articles were published in the last 3 years.…”

Section: Introductionmentioning

confidence: 99%

The relationship between bupropion and suicide in post-mortem investigations

Kriikku

Ojanperä

2016

Forensic Science International

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We reviewed the 33727 postmortem toxicology investigations performed in Finland over a period of 5years (2009-2013) and identified those in which the antidepressant bupropion was detected. Cases positive for other antidepressant drugs were reviewed for comparison. The postmortem toxicological examination included, in all cases, the routine screening and quantification of hundreds of drugs and poisons using quality-controlled methods. Bupropion was detected in 65 cases. A large proportion of the bupropion-positive deaths resulted from suicide (55%). In fatal poisoning cases found positive for bupropion, the proportion of suicide was even higher (77%). The measured median bupropion postmortem blood concentration (0.69mg/L) was markedly higher than the normal therapeutic range in plasma in the treatment of depression (up to 0.1mg/L) and even higher in fatal bupropion poisonings (13mg/L). Only 14% of the deceased positive for bupropion were estimated to be drug abusers. However, nearly all of the drug abuse cases were from the last year of the study (2013), indicating a recent increase of the use of bupropion among drug abusers and possibly even abuse of bupropion itself. Suicide victims positive for bupropion were younger than those who died with other antidepressant drugs in their blood. In addition, the percentage of fatal poisonings among bupropion-positive postmortem cases was higher than among the users of other antidepressant drugs. Suicide was significantly more common among the deceased positive for bupropion than among users of other antidepressant drugs. An unknown degree of bupropion degradation before the assay and post-mortem redistribution of bupropion may have impacted the measured levels. Nonetheless, all post-mortem concentrations of bupropion were elevated and especially high concentrations were detected in suicides.

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Effects of repeated treatment with monoamine-transporter-inhibitor antidepressants on pain-related depression of intracranial self-stimulation in rats

2020

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Synaptic neurotransmission with dopamine (DA), norepinephrine (NE), and serotonin (5-HT) is terminated primarily by reuptake into the presynaptic terminal via the DA, NE, and 5-HT transporters (DAT/NET/SERT, respectively). Monoamine transporter inhibitors constitute one class of drugs used to treat pain, and emergence of analgesic effects by these compounds often requires repeated treatment for days or weeks. The present study compared antinociceptive effects produced by repeated treatment with monoamine transporter inhibitors in a preclinical assay of pain-related depression of positively reinforced operant responding. Adult male Sprague-Dawley rats equipped with microelectrodes targeting a brain-reward area responded for pulses of electrical brain stimulation in an intracranial self-stimulation (ICSS) procedure.Intraperitoneal injection of dilute lactic acid served as a noxious stimulus that repeatedly depressed ICSS and also produced weight loss during 7 days of repeated acid administration.Both acid-induced ICSS depression and weight loss were blocked by repeated pretreatment with the nonsteroidal anti-inflammatory drug ketorolac (a positive control) but not by the kappa opioid receptor agonist U69,593 (a negative control). Like ketorolac, the DAT/NET inhibitor bupropion fully blocked acid-induced ICSS depression and weight loss throughout all 7 days of treatment. Conversely, the NET-selective inhibitor nortriptyline and SERT-selective inhibitor citalopram produced antinociception only after several days of repeated treatment, and weight loss was attenuated by citalopram but not by nortriptyline. These results support effectiveness of bupropion to alleviate signs of pain-related behavioral depression in rats and further suggest that nortriptyline and citalopram produce a more gradual onset of antinociception during repeated treatment.

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Bupropion abuse and overdose

Cited by 40 publications

References 0 publications

Successful management of bupropion poisoning: possible benefit of acidosis treatment

Successful management of bupropion poisoning: possible benefit of acidosis treatment

The relationship between bupropion and suicide in post-mortem investigations

Effects of repeated treatment with monoamine-transporter-inhibitor antidepressants on pain-related depression of intracranial self-stimulation in rats

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