Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2014.02.013
Brazilian Journal of Anesthesiology
Clinical Informations

Seizure due to multiple drugs intoxication: a case report

Convulsão por causa de intoxicação por múltiplas drogas: relato de caso

Handan Gulec; Munire Babayigit; Aysun Kurtay; Mehmet Sahap; Fatma Ulus; Zehra Tutal; Eyup Horasanli

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Abstract

Abstract The mechanism of the antidepressant effect of bupropion is not fully understood. Besides, using it in the treatment of depression, it is found to be effective in reducing withdrawal symptoms due to smoking cessation. A 28-year-old female patient with a history of depression was admitted to emergency department an hour after ingestion of bupropion, quetiapine, and levothyroxine in high doses to commit suicide. While accepting her into the Intensive Care Unit, she was awake, alert, disoriented and agitated. After 2 h, the patient had a generalized tonic-clonic seizure. The necessary treatment was given and 9 h later with hemodynamic improvement, the patients’ mental status improved. Bupropion may cause unusual behaviors such as delusions, paranoia, hallucinations, or confusion. The risk of seizure is strongly dose-dependent. We want to emphasize the importance of early gastric lavage and administration of activated charcoal.

Keywords

Bupripion, Intensive care unit, Seizure

Resumo

Resumo O mecanismo do efeito antidepressivo de bupropiona ainda não está bem esclarecido. Contudo, seu uso no tratamento de depressão revelou ser eficaz para reduzir os sintomas de abstinência relacionados à cessação do tabagismo. Uma paciente do sexo feminino, 28 anos, com história de depressão, deu entrada no setor de emergência uma hora após a ingestão de bupropiona, quetiapina e levotiroxina em doses elevadas para cometer suicídio. Ao ser internada em unidade de terapia intensiva, estava acordada, alerta, desorientada e agitada. Após duas horas, apresentou uma crise tônico-clônica generalizada. O tratamento necessário foi administrado e nove horas mais tarde, com a estabilização hemodinâmica, o estado mental da paciente melhorou. Bupropiona pode causar comportamentos incomuns, incluindo delírios, paranoia, alucinações ou confusão mental. O risco de convulsão é altamente dependente da dose. Queremos enfatizar a importância da lavagem gástrica precoce e da administração de carvão ativado.

Palavras-chave

Bupropiona, Unidade de terapia intensiva, Convulsão

References

Ascher JA, Cole JO, Colin NJ. Bupropion: a review of its mechanism of antidepressant activity. J Clin Psychiatry. 1995;56:395-401.

Richmond R, Zwar N. Reviewer of bupropion for smoking cessation. Drug Alchol Rev. 2003;22:203-20.

Hurt RD, Sachs DP, Glover ED. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med. 1997;337:1195-202.

Johnston AJ, Ascher J, Leadbetter R. Pharmacokinetic optimisation of sustained-release bupropion for smoking cessation. Drugs. 2002;62(^sSuppl 2):11-24.

Sigg T. Recurrent seizures from sustained-release bupropion. Int J Med Toxicol. 1999;2:4.

Friel PN, Logan BK, Fligner CL. Three fatal drug overdoses involving. Bupropion. J Anal Toxicol. 1993;17:436-8.

White RS, Langford JR. Sustained release bupropion: overdose and treatment. Am J Emerg Med. 2002;20:388-9.

Position statement: single-dose activated charcoal. Clin Toxicol. 1997;35:721-41.

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