TY - JOUR
T1 - Factors associated with seizure development after bupropion overdose
T2 - a review of the toxicology investigators consortium
AU - on behalf of the Toxicology Investigators Consortium (ToxIC)
AU - Rianprakaisang, Tony N.
AU - Prather, Colin T.
AU - Lin, Amber L.
AU - Murray, Brian P.
AU - Hendrickson, Robert G.
N1 - Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Background: Bupropion is an aminoketone antidepressant. A major concern in bupropion toxicity is seizure activity, which can occur up to 24 h from ingestion. It is difficult to predict which patients will have seizures. The purpose of this study is to identify clinical features associate with seizure after bupropion overdose. Methods: We searched the Toxicology Investigators Consortium registry for a cases of poisoning by bupropion between January 1, 2014 and January 1, 2017 in patients aged 13–65. Demographic variables and clinical features were compared between patients who did and did not experience a seizure and presented as unadjusted odds ratios (OR). Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) between clinical features and seizures. Results: There were 256 cases of bupropion overdose remaining after inclusion/exclusion criteria were applied. Clinical features associated with seizure were QTc >500 (OR = 3.4, 95% CI: 1.3–8.8, p = 0.012), tachycardia (p > 140) (OR = 1.9, 95% CI: 1–3.561, p = 0.05), and age 13–18 years (2.4, 95% CI: 1.3–4.3, p = 0.005). The mean QTc value for patients experiencing a seizure was 482 ms (N = 95 IQR: 59 ms) versus 454 ms (N = 103, IQR: 43) in patients who did not experience seizure, however, it was not possible to identify a QTc cutoff with sensitivity or specificity to predict seizures. Conclusion: Based on our analysis of data from the ToxIC registry, age (13–18), tachycardia (p > 140) and QTc >500 ms are associated with seizures in bupropion overdose; however, a specific QTc value may not be a useful predictor of seizures.
AB - Background: Bupropion is an aminoketone antidepressant. A major concern in bupropion toxicity is seizure activity, which can occur up to 24 h from ingestion. It is difficult to predict which patients will have seizures. The purpose of this study is to identify clinical features associate with seizure after bupropion overdose. Methods: We searched the Toxicology Investigators Consortium registry for a cases of poisoning by bupropion between January 1, 2014 and January 1, 2017 in patients aged 13–65. Demographic variables and clinical features were compared between patients who did and did not experience a seizure and presented as unadjusted odds ratios (OR). Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) between clinical features and seizures. Results: There were 256 cases of bupropion overdose remaining after inclusion/exclusion criteria were applied. Clinical features associated with seizure were QTc >500 (OR = 3.4, 95% CI: 1.3–8.8, p = 0.012), tachycardia (p > 140) (OR = 1.9, 95% CI: 1–3.561, p = 0.05), and age 13–18 years (2.4, 95% CI: 1.3–4.3, p = 0.005). The mean QTc value for patients experiencing a seizure was 482 ms (N = 95 IQR: 59 ms) versus 454 ms (N = 103, IQR: 43) in patients who did not experience seizure, however, it was not possible to identify a QTc cutoff with sensitivity or specificity to predict seizures. Conclusion: Based on our analysis of data from the ToxIC registry, age (13–18), tachycardia (p > 140) and QTc >500 ms are associated with seizures in bupropion overdose; however, a specific QTc value may not be a useful predictor of seizures.
KW - Bupropion
KW - Clinical Features
KW - Overdose
KW - Predictors
KW - Seizures
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U2 - 10.1080/15563650.2021.1913180
DO - 10.1080/15563650.2021.1913180
M3 - Article
C2 - 33878992
AN - SCOPUS:85104761819
SN - 1556-3650
VL - 59
SP - 1234
EP - 1238
JO - Clinical Toxicology
JF - Clinical Toxicology
IS - 12
ER -