Document Detail


Bupropion overdose: QTc prolongation and its clinical significance.
MedLine Citation:
PMID:  12841807     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the cardiotoxicity of bupropion hydrochloride in deliberate self-poisoning. METHODS: A prospective study was conducted in a national poisons information center (PIC) of cases of adult deliberate self-poisoning with medical record follow-up of the patients. Fifty-nine cases of bupropion deliberate self-poisoning managed in the hospital, in which the New South Wales PIC was contacted for advice, were evaluated from November 2000 through July 2001. Clinical effects and electrocardiographic (ECG) parameters (QRS, QT, QTc) were the main outcome measures. RESULTS: ECGs were available for 17 of the 59 patients for analysis, 9 patients (53%) were women, and median patient age was 28 years (interquartile range 22-37). The mean +/- SD ingested bupropion dose was 3.8 +/- 3.1 g. Tachycardia occurred in 13 patients (76%; 95% CI 50 to 93) and hypertension in 8 patients (47%). There were no reports of hypotension or arrhythmias. There was a significantly increased QTc of 461 +/- 34 msec in the patients with bupropion overdose compared with previously developed controls; 13 of the 17 cases had a QTc >440 msec (76%; 95% CI 50 to 93). The uncorrected QT interval did not differ from that of controls. CONCLUSIONS: A moderately prolonged QTc (>440 msec) is common in bupropion overdose. However, this may not be a result of intrinsic cardiac toxicity, but overcorrection of the QTc due to the tachycardia that occurs. It is important that the QTc is interpreted with caution in overdoses of agents that cause significant tachycardia (>100 beats/min).
Authors:
Geoffrey K Isbister; Corrine R Balit
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  37     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:    2003 Jul-Aug
Date Detail:
Created Date:  2003-07-04     Completed Date:  2003-09-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  999-1002     Citation Subset:  IM    
Affiliation:
University of Newcastle, Waratah, Australia. gsbite@bigpond.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Antidepressive Agents, Second-Generation / poisoning*
Australia
Bupropion / poisoning*
Delayed-Action Preparations
Electrocardiography / drug effects
Female
Humans
Long QT Syndrome / chemically induced*,  physiopathology
Male
Overdose
Prospective Studies
Suicide, Attempted
Chemical
Reg. No./Substance:
0/Antidepressive Agents, Second-Generation; 0/Delayed-Action Preparations; 34841-39-9/Bupropion

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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