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J Pediatr Intensive Care 2019; 08(04): 242-246
DOI: 10.1055/s-0039-1693483
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Successful Management of Adolescent Bupropion Overdose with Intravenous Lipid Emulsion Therapy

Kasha Bornstein 
1   University of Miami Miller School of Medicine, Miami, Florida, United States
,
Tim Montrief
2   Department of Emergency Medicine, University of Miami, Jackson Memorial Hospital/Miller School of Medicine, Miami, United States
,
Mehruba Anwar Parris
2   Department of Emergency Medicine, University of Miami, Jackson Memorial Hospital/Miller School of Medicine, Miami, United States
› Author Affiliations Funding None.
Further Information

Publication History

15 May 2019

11 June 2019

Publication Date:
25 July 2019 (online)

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Abstract

Bupropion overdose in the pediatric setting poses significant potential for toxicity. We present the case of a 15-year-old female patient presenting with intentional bupropion overdose resulting in generalized tonic–clonic seizures, severe acidosis, vomiting, and tachycardia after ingestion of between 1,650 to 9,000 mg (24–133 mg/kg) of bupropion. The patient was admitted to pediatric intensive care unit (PICU) where toxicity was resolved promptly following administration of intravenous lipid emulsion (ILE) infusion. ILE is a first-line treatment for other forms of toxicity including unintended local anesthetic administration. ILE use is not a first-line treatment in this setting, but this case presents a positive subsequent patient outcome.

Keywords

Bupropion - Wellbutrin - lipid emulsion therapy - antidepressant - overdose

Note

This report describes a case of intentional severe bupropion overdose in an adolescent patient and successful management of sequelae with intravenous lipid emulsion therapy.


Authors' Contribution

M.A.P. and T.M. conceptualized the case report and provided edits and revision. K.B. drafted the initial manuscript and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.