Reactions 1475, p11 - 26 Oct 2013 O S Bupropion overdose Persistent status epilepticus: case report A 36-year-old woman experienced persistent status epilepticus after an overdose of bupropion. The woman was admitted to an ICU with headache and somnolence 4 hours after ingesting 30 tablets of bupropion 300mg (total 9g); her symptoms had started approximately 2 hours after ingestion. She had recently started receiving bupropion to facilitate smoking cessation. On admission, she had a Glasgow Coma Score (GCS) of 9, with tonic clonic seizures. The woman was initially managed with charcoal and diazepam, and she was mechanically ventilated after her GCS decreased to 6. Due to persisting generalised seizures, she started receiving thiopental sodium. She experienced a recurrence of seizures after thiopental sodium was stopped, and the drug was restarted multiple times. She also received dopamine for decreased BP, and a tracheostomy was performed on hospital day 7. Thereafter, thiopental sodium was successfully withdrawn, and she received further treatment with phenobarbital and valproic acid. She recovered completely and was discharged from ICU. Author comment: "This rare case of status epilepticus due to intoxication with 9 gm of bupropion describes survival of a patient after one of the highest ingested [dosages]." Duger C, et al. Persistent status epilepticus due to bupropion intoxication. Anaesthesia, Pain and Intensive Care 16: 302-304, No. 3, Sep-Dec 2012. Available from: URL: http://www.apicareonline.com/?p=1509 - Turkey 803094821 1 Reactions 26 Oct 2013 No. 1475 0114-9954/13/1475-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved

Bupropion overdose

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Reactions 1475, p11 - 26 Oct 2013

O SBupropion overdose

Persistent status epilepticus: case reportA 36-year-old woman experienced persistent status

epilepticus after an overdose of bupropion.The woman was admitted to an ICU with headache and

somnolence 4 hours after ingesting 30 tablets of bupropion300mg (total 9g); her symptoms had started approximately2 hours after ingestion. She had recently started receivingbupropion to facilitate smoking cessation. On admission, shehad a Glasgow Coma Score (GCS) of 9, with tonic clonicseizures.

The woman was initially managed with charcoal anddiazepam, and she was mechanically ventilated after her GCSdecreased to 6. Due to persisting generalised seizures, shestarted receiving thiopental sodium. She experienced arecurrence of seizures after thiopental sodium was stopped,and the drug was restarted multiple times. She also receiveddopamine for decreased BP, and a tracheostomy wasperformed on hospital day 7. Thereafter, thiopental sodiumwas successfully withdrawn, and she received furthertreatment with phenobarbital and valproic acid. She recoveredcompletely and was discharged from ICU.

Author comment: "This rare case of status epilepticus dueto intoxication with 9 gm of bupropion describes survival of apatient after one of the highest ingested [dosages]."Duger C, et al. Persistent status epilepticus due to bupropion intoxication.Anaesthesia, Pain and Intensive Care 16: 302-304, No. 3, Sep-Dec 2012. Availablefrom: URL: http://www.apicareonline.com/?p=1509 - Turkey 803094821