UMEM Educational Pearls

Category: Toxicology

Title: Bupropion overdose in adolescents

Keywords: Bupropion, TCAs, adolescents (PubMed Search)

Posted: 12/20/2018 by Hong Kim, MD, MPH
Click here to contact Hong Kim, MD, MPH

Selective serotonin reuptake inhibitors are the most common anti-depressant used today. However, the use bupropion in adolescents is increasing due the belief that it has fewer side effects than TCAs.

Using the National Poison Data System (2013 – 2016), the adverse effects of bupropion were compared to TCA in adolescents (13 – 19 years old) with a history of overdose (self harm). 

Common clinical effects were:

TCA:  n=1496; Bupropion: n=2257

Clinical effects

TCAs

Bupropion

Tachycardia

59.9%

70.7%

Drowsiness/lethargy

51.5%

18.1%

Conduction disturbance 

22.2%

15.6%

Agitation

19.1%

16.4%

Hallucination/delusions

4.2%

23.9%

Seizure

3.9%

30.7%

Vomiting

2.7%

20.0%

Tremor

3.7%

18.1%

Hypotension

2.7%

8.0%

Death

0.3%

0.3%

 

Conclusion:

Bupropion overdose results in significant adverse effects in overdose; however, death is relatively rare.

 

References

Sheridan DC et al. Suicidal bupropion ingestions in adolescents: increased morbidity compared to other antidepressants. Clin Toxicol. 2018;56:360-364.