Clinical effects of intravenous bupropion misuse reported to a regional poison center

McCabe, Daniel J.; McGillis, Eric; Willenbring, Benjamin A.

doi:10.1016/j.ajem.2021.03.061

Cited by 9 publications

(11 citation statements)

References 34 publications

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“…10 The systematic review by Aikoye et al includes only studies with patients in the American prison system. 13 Five additional case reports published after the review by Naglich et al were included in our systematic review, [20][21][22][23]29 along with 2 retrospective observational studies of bupropion overdose reports to regional poison control centers. 18,22 This large sample of patients contains percentage reports of presenting symptoms that add clinical value and enable physicians to identify possible bupropion overdoses by most frequent presenting symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Seven hundred forty-eight cases were oral ingestions (31.6%), with 17 cases of unknown route of intake. 9,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The reported effects of insufflation or IV injections of bupropion are a milder "cocaine-like" high that is brief (30 seconds to 5 minutes), with fewer withdrawal cravings and fewer "comedown" effects. 12 Agitation and anxiety were identified as common withdrawal symptoms.…”

Section: Patterns Of Use Dosages and Described Effectsmentioning

confidence: 99%

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Clinical Presentations of Bupropion Prescription Drug Misuse

Noe,

Shah,

Ongchuan

et al. 2024

J Clin Psychopharmacol

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Background Among prescribers, bupropion is considered a substance of low misuse potential, with some studies showing lesser misuse potential than caffeine. However, several case reports exist of recreational bupropion misuse and diversion. Our goal is to understand at-risk populations, clinical courses, interventions, and outcomes after acute ingestion of bupropion via oral, intravenous route, and insufflation. Methods The systematic review was registered with PROSPERO on August 5, 2023. We conducted a systematic literature search on July 30, 2023, utilizing 8 databases with the help of the Medical Subject Headings (MeSH) term “Bupropion” in the context of misuse and abuse. Ultimately, we found 17 articles with qualitative synthesis relevant to our study objective and meeting our inclusion/exclusion criteria. Results Bupropion insufflation and intravenous injection occur almost exclusively in patients with a substance use disorder history, with a preponderance of patients with stimulant use disorder or multiple substance use disorders. Additionally, many were dual-diagnosis patients with a history of attention deficit hyperactivity disorder and stimulant use disorder, treated with bupropion. Patients describe the effects of bupropion insufflation/IV injection as a milder “cocaine-like” high that is brief, with less severe withdrawal effects of anxiety and agitation. The most common side effect at presentation was tachycardia, followed by seizures responsive to IV benzodiazepines. IV injection seems particularly insulting to the vascular system, with cellulitis, tissue necrosis, and digital ischemia as documented adverse effects. Conclusions This systematic review highlights the bupropion misuse potential in certain patient populations and serves to increase awareness among clinicians. Additional patient screening, monitoring and follow-up, surveillance, and further research are needed to investigate and prevent bupropion misuse in at-risk patient populations entirely.

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Section: Discussionmentioning

confidence: 99%

Section: Patterns Of Use Dosages and Described Effectsmentioning

confidence: 99%

Clinical Presentations of Bupropion Prescription Drug Misuse

Noe,

Shah,

Ongchuan

et al. 2024

J Clin Psychopharmacol

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“…For instance, in the last 20 years, published case reports/series have described the misuse of gabapentin, 27 quetiapine, [28][29][30] venlafaxine, 31 and bupropion. 32,33 These types of case reports/series can alert providers of the potential for misuse of some of the commonly prescribed medications in psychiatry.…”

Section: The Role Of Case Reports/series In Questions Of Diagnosis Et...mentioning

confidence: 99%

“…A final potentially helpful role for case reports is in alerting providers to the potential that patients may misuse approved medications for hedonic or other purposes. For instance, in the last 20 years, published case reports/series have described the misuse of gabapentin, 27 quetiapine, 28–30 venlafaxine, 31 and bupropion 32,33 . These types of case reports/series can alert providers of the potential for misuse of some of the commonly prescribed medications in psychiatry.…”

Section: The Role Of Case Reports/series In Questions Of Diagnosis Et...mentioning

confidence: 99%

The Role of Case Series and Case Reports in Evidence-Based Medicine

Smith,

Patel

2024

J Clin Psychopharmacol

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“…Because of its similarity to these stimulants, bupropion is sometimes intentionally insufflated or injected for euphoric effects. 58,59 In addition, it is frequently a false positive for amphetamine on urine drug screen. 60 Mechanistically, norepinephrine and dopamine reuptake blockade at the neuronal synapse are responsible for bupropion's psychoactive effect.…”

Section: Introductionmentioning

confidence: 99%

Part I: Case series: Acute management of prescription and nonprescription drug overdoses

Feldman,

Leonard

2024

J Am Coll Clin Pharm

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Reviewed by Julianne Yeary, Pharm.D., BCCCP; and Monica Owen, Pharm.D., BCPS, BCCCP LEARNING OBJECTIVES 1. Classify prescription drug overdose by patient presentations.2. Evaluate the causative agents of a drug overdose based on history and clinical findings of presentation.3. Develop a treatment paradigm that may be applied in all prescription drug overdoses.4. Assess the relevance of each therapeutic target in drug overdose in a specific drug overdose scenario.5. Devise a plan for treatment of anticholinergic, sodium channel blocker, tricyclic antidepressant, bupropion, digoxin, sulfonylurea, alpha-2 agonist, iron, valproic acid, clonidine, and salicylate overdose.6. Justify the use of specific antidotes in overdose.Target audience for this application-based activity: Pharmacotherapy specialists and advanced level clinical pharmacists whose practice involves the direct care and management of critically ill patients in the ICU and emergency department.

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Clinical effects of intravenous bupropion misuse reported to a regional poison center

Cited by 9 publications

References 34 publications

Clinical Presentations of Bupropion Prescription Drug Misuse

Clinical Presentations of Bupropion Prescription Drug Misuse

The Role of Case Series and Case Reports in Evidence-Based Medicine

Part I: Case series: Acute management of prescription and nonprescription drug overdoses

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