Cardiotoxicity following bupropion overdose.

OBJECTIVE

To determine whether bupropion overdose has been associated with cardiovascular toxicity.

DATA SOURCES

MEDLINE (1966-January 2002), EMBASE (1980-January 2002), Current Contents (January 2002), and PubMed (January 2002) databases for English-language human reports. Search terms included bupropion, overdose (drug), intoxication, poisoning, and acute ingestion.

DATA SYNTHESIS

Articles describing toxicity following bupropion overdose were evaluated independently by both authors to identify cases of cardiotoxicity.

RESULTS

Thirteen articles describing bupropion overdose in 116 patients were identified. Only 3 patients exhibited cardiotoxicity following acute ingestion; 2 of these patients also ingested other medications. All 3 patients experienced tachycardia and conduction delays (widened QRS complex and/or prolonged QTc interval), but none of these delays progressed to a life-threatening arrhythmia. All patients recovered, with resolution of cardiotoxicity within 2-4 days following ingestion.

CONCLUSIONS

We recommend that all patients with an overdose of bupropion should have an electrocardiogram performed on admission and should be monitored for the development of conduction delays and/or life-threatening arrhythmias.