Bupropion overdose: A 3-year multi-center retrospective analysis

Spiller, Henry A.; Ramoska, Edward A.; Krenzelok, Edward P.; Sheen, Sandra R.; Borys, Douglas J.; Villalobos, Daniel; Muir, Scott; Jones-Easom, Leslie

doi:10.1016/0735-6757(94)90195-3

Cited by 106 publications

(60 citation statements)

References 2 publications

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“…In most published cases, the ingested dose was much lower and was responsible for less severe clinical effects (4): generalized seizures easily controlled by benzodiazepines (5-7), sinus tachycardia (5,(8)(9)(10), conduction disorders with widening of the QRS complex (11), and prolongation of the QT interval (12)(13)(14). These effects return to baseline within several hours (5,10,15).…”

Section: Discussionmentioning

confidence: 99%

Cardiogenic shock and status epilepticus after massive bupropion overdose

Morazin

Lumbroso

Harry

et al. 2007

Clinical Toxicology

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Background. To describe a profound cardiac dysfunction and a status epilepticus after a massive bupropion overdose. Case report. A 35-year-old man was admitted in coma following the deliberate ingestion of 12 g of bupropion. The course was marked by the rapid onset of severe and prolonged status epilepticus and cardiogenic shock. Plasma bupropion level determined four hours after the estimated time of ingestion was 1.4 mg/L. All clinical features resolved completely in response to symptomatic treatment. Conclusion. Several cases of bupropion overdose, with sinus tachycardia and seizures rapidly corrected by symptomatic treatment, have been reported in the literature. To our knowledge, this case of overdose with bupropion alone, at very high doses, is the first to describe clinical features comprising severe and prolonged status epilepticus and direct cardiotoxicity with the development of cardiogenic shock documented by echocardiogram.

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Section: Discussionmentioning

confidence: 99%

Cardiogenic shock and status epilepticus after massive bupropion overdose

Morazin

Lumbroso

Harry

et al. 2007

Clinical Toxicology

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“…Bupropion, maprotiline, and amoxapine are the ADs with the strongest proconvulsant properties and should be avoided in epileptic patients (98,110,111). The incidence of seizures with different ADs is summarized in Table 2.…”

Section: Proconvulsant Properties Of Adsmentioning

confidence: 99%

Depression in Epilepsy: A Common but Often Unrecognized Comorbid Malady

Kanner

Palac

2000

Epilepsy & Behavior

152

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“…Observational studies have shown that bupropion causes increased risk of seizures at doses ‡ 600 mg. The risk for seizures is highly dose dependent; seizure activity occurred in 21% of patients with overdose (Spiller et al 1994). Some studies have suggested that sustained-release and extended-release bupropion may have a delayed onset of seizures within 24 hours after ingestion.…”

Section: Discussionmentioning

confidence: 99%

“…A PubMed search performed using keywords ''hypokalemia'' and both ''Wellbutrin'' and ''bupropion'' did not yield any results. Notably, a three-year, multicenter, retrospective analysis of bupropion overdose reported hypokalemia in three out of five patients in whom potassium levels were reported (Spiller et al 1994). As J.…”

Section: Discussionmentioning

confidence: 99%

Hypokalemia Secondary to Bupropion Sustained Release Overdose

Wilson

Paul²,

Mehta³

2013

Journal of Child and Adolescent Psychopharmacology

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Chief Complaint and Presenting Problem J. was a 17-year-old African American girl who was admitted to a public crisis stabilization unit with a diagnosis of major depressive disorder (MDD) after making a suicide attempt by overdose. J. was living in a relative foster home with her aunt and was a senior in high school. History of Present IllnessJ. had been struggling with depressive symptoms for nearly 3 years. J. had experienced onset of decreased appetite, poor hygiene, poor sleep, decreased social interaction, listlessness, apathetic affect, and anhedonia at age 14, and she was subsequently diagnosed with major depressive disorder at age 15. She was treated with medication management by an outpatient psychiatrist. Stressors over the past 2 years had included felony fraud charges related to stealing family credit card numbers and an associated 2 week sentence at the local county jail. J. experienced a second major depressive episode following release from jail. She also had experienced significant social stressors including out-of-home placement, conflicts with friends, domestic violence in her home, and declining academic performance.J. had been hospitalized in the past for a suicide attempt on an unknown quantity of 40 mg capsules of fluoxetine without serious medical complications. The suicide attempt was triggered by ongoing relationship conflicts with mother and was precipitated when her mother took away her phone privileges. J. had not been able to maintain her previous level of academic performance; as a result of worsening depressive symptoms and psychiatric hospitalizations, her grades were declining.J. had an extended history of oppositional defiant behavior, including disobedience and verbal aggression directed toward her mother, but no reported suspensions or expulsions.J. had been admitted to a pediatric hospital earlier in the year of the suicide attempt discussed here, after being struck by her mother with a mirror and trophy on her head, right arm, and right leg. This led to a Child Protective Services (CPS) referral and J.'s aunt was given custody following two group home placements.Prior to the current admission, J. had been asked to clean her room by her aunt and told she could not visit with her mother until this was finished. J. made a suicide attempt by ingesting *30 150 mg tablets of sustained-release bupropion. J.'s aunt was alerted when she heard a loud thumping sound upstairs where J. was found unresponsive on the floor. J.'s aunt called 911, and J. was transported to the local emergency department, where she had a seizure.According to hospital records, J.'s seizure lasted 1 minute and was characterized by extremity jerking for a few seconds, fixed eye deviation to one side, and foaming at the mouth. She was administered lorazepam in the emergency department and the seizures stopped. Initial evaluation revealed a nongapped hypokalemic, hyperchloremic metabolic acidosis, hypocalcemia, and hypoglycemia. J. was administered ondansetron, ranitidine, potassium chloride and D5 ½ normal salin...

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Bupropion overdose: A 3-year multi-center retrospective analysis

Cited by 106 publications

References 2 publications

Cardiogenic shock and status epilepticus after massive bupropion overdose

Cardiogenic shock and status epilepticus after massive bupropion overdose

Depression in Epilepsy: A Common but Often Unrecognized Comorbid Malady

Hypokalemia Secondary to Bupropion Sustained Release Overdose

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