Medical Toxicology Consultation Service, Kaiser Permanente Northern California, Sacramento, CA, USA.
College of Medicine, California North State University, Elk Grove, CA, USA.
Clin Toxicol (Phila). 2020 Dec;58(12):1306-1312. doi: 10.1080/15563650.2020.1742919. Epub 2020 Mar 26.
Bupropion is an antidepressant that is commonly known to cause seizures in overdose. Because of concern for delayed onset of seizures, patients are frequently observed for prolonged periods after overdose. The primary objective is to evaluate the incidence and clinical parameters associated with late seizures following bupropion overdose. This retrospective study of acute bupropion overdose who presented to 26 different hospitals in California and Arizona during an 8 year time period. 437 patients were identified. Tachycardia and altered mental status were common. A total of 122 (27.9%) patients had seizures following their overdose. Only eight patients (1.8%) had a seizure more than 8 h after hospital arrival. None of these patients were asymptomatic on arrival. Among patients with tachycardia on arrival, the odds of having a seizure was 6.7 (95% CI 3.7-10.9); the odds of a seizure more than 8 h after arrival was 5.24 (95% CI 1.2-23.5). Similarly, altered mental status on arrival was significantly associated with the risk of a seizure; OR 3.93 (95% CI 2.21-7.0). Seizures are relatively common, and are associated with antecedent tachycardia or altered mental status.
安非他酮是一种常用的抗抑郁药，过量使用时会引起癫痫发作。由于担心癫痫发作延迟，患者在过量用药后通常会被密切观察很长时间。本研究的主要目的是评估安非他酮过量后迟发性癫痫发作的发生率和相关临床参数。本回顾性研究纳入了在加利福尼亚州和亚利桑那州的 26 家不同医院就诊的 8 年间急性安非他酮过量患者。共确定了 437 名患者。心动过速和意识改变是常见的。共有 122 名（27.9%）患者在过量用药后出现癫痫发作。只有 8 名（1.8%）患者在入院后 8 小时以上出现癫痫发作。这些患者在入院时均无无症状。入院时存在心动过速的患者发生癫痫的几率为 6.7（95%CI 3.7-10.9）；入院 8 小时后发生癫痫的几率为 5.24（95%CI 1.2-23.5）。同样，入院时意识改变与癫痫发作风险显著相关；OR 3.93（95%CI 2.21-7.0）。癫痫发作较为常见，与先前存在的心动过速或意识改变相关。
