Hasan KARA, Ayşegül BAYIR, Ahmet AK, Demet ACAR, Rabia İSTANBULLUOĞLU, Selim DEĞİRMENCİ

Seizures after overdoses of bupropion intake

Background: Bupropion is a new-generation monocyclic antidepressant that has been accidentally found to have potential effects on reducing nicotine addiction. It is structurally similar to stimulants such as amphetamine and inhibits dopamine and noradrenalin reuptake selectively. Case Reports: We report two cases with no history of epilepsy who took oral bupropion for depression and had generalised tonic-clonic type of seizures in their follow-ups. Conclusion: After an overdose of bupropion, clinical effects are seen primarily on the neurological, cardiovascular, and gastrointestinal systems. Neuro- logical effects can include tremor, confusion, agitation, hallucinations, coma, and seizures.

PDF

___

1. Spiller HA, Schaeffer SE. Multiple seizures after bupropion over- dose in a small child. Pediatr Emerg Care 2008;24:474-5.
2. Gobbi G, Slater S, Boucher N, Debonnel G, Blier P. Neurochemical and psychotropic effects of bupropion in healthy male subjects. J Clin Psychopharmacol 2003;23:233-9.
3. Biswas AK, Zabrocki LA, Mayes KL, Morris-Kukoshi CL. Cardiotoxicity associated with intentional ziprasidone and bupropion overdose. J Toxicol Clin Toxicol 2003;41:79-82.
4. Pesola GR, Avarsarala J. Bupropion seizure proportion among new-onset generalized seizures and drug related seizures presenting to an emergency department. J Emerg Med 2002;22:235-9.
5. Lowenstein DH, Alldredge BK. Status epilepticus at an urban public hospital in the 1980s. Neurology 1993;43:483-8.
6. Alldredge BK, Lowenstein DH, Simon RP. Seizures associated with recreational drug abuse. Neurology 1989;39:1037-9.
7. Britton J, Jarvis MJ. Bupropion:a new treatment for smokers. Nicotine replacement treatment should also be available on the NHS. BMJ 2000;321:65-6.
8. Montgomery SA. Antidepressants and seizures:emphasis on newer agents and clinical implications. Int J Clin Pract 2005;59:1435-40.
9. Thundiyil JG, Kearney TE, Olson KR. Evolving epidemiology of drug-induced seizures reported to a Poison Control Center System. J Med Toxicol 2007;3:15-9.
10. Stahl SM, Pradko JF, Haight BR, Modell JG, Rockett CB, Learned- Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Prim Care Companion J Clin Psychiatry 2004;6:159-66.
11. Rohrig TP, Ray NG. Tissue distribution of bupropion in fatal over- dose. J Anal Toxicol 1992;16:343-5.
12. Starr P, Klein-Schwartz W, Spiller H, Kem P, Ekleberry SE, Kunkel S. Incidence and onset of delayed seizures after overdoses of extended-release bupropion. Am J Emerg Med 2009;27:911-5.
13. Balit CR, Lynch CN, Isbister GK. Bupropion poisoning:a case se- ries. Med J Aust 2003;178:61-3.