Avoidance of other anti-epileptics, including phenytoin, is recommended, given possible drug-drug interactions. Seizures should be treated with benzodiazepines as first-line agents and barbiturates, such as phenobarbital, as second-line agents. Unintentional overdose rarely causes significant clinical effects however, major adverse reactions (seizures) have been reported even in double-dose ingestions. Decontamination with activated charcoal may be appropriate for patients presenting soon after a large overdose and who do not need airway protection. Consultation with a regional poison center or toxicologist may be helpful, especially in critical cases with serious organ-system dysfunction. Primary management of bupropion overdose is supportive care, as no direct antidote exists. Status epilepticus, life-threatening arrhythmias, and cardiogenic shock have all been reported in overdose. The extended-release formulation has also been associated with delayed seizures for up to 24 hours after ingestion. Overdose is frequently associated with seizures, tachycardia, and agitation. The risk of seizures with daily doses below 300 mg is estimated at 0.1% but increases to 0.4% with doses up to 450 mg daily. The drug is now contraindicated in patients with seizure history, eating disorders, or those undergoing ethanol or CNS depressant withdrawal. Bupropion was withdrawn in 1986 after new-onset seizures were reported in a small portion of bulimic patients however, it was reintroduced in 1989 at lower dose ranges. Īdverse drug effects with therapeutic dosing are nonspecific and may include dry mouth, constipation, headache, nausea, agitation, insomnia, and weight loss. Multiple formulations exist, including immediate-release (IR), sustained-release (SR), and extended-release (XL). It is currently FDA-approved for treating major depressive disorder, seasonal affective disorder, and smoking cessation with several off-label uses, including sexual dysfunction secondary to antidepressant use, generalized anxiety disorder, ADHD, and bipolar disorder. Bupropion hydrochloride is an antidepressant drug belonging to the aminoketone class first introduced in 1985.
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