Treatment of Bupropion Toxicity with Lipid Emulsion

Lee, Soo Hee; Sohn, Ju-Tae

doi:10.1055/s-0040-1702234

Cited by 1 publication

(1 citation statement)

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“…Shepherd et al and Spiller et al demonstrated the efficacy of lipid emulsion therapy in intentional bupropion overdoses, while Gosselin et al established evidence-based recommendations for its use in managing toxicological emergencies [4][5][6] . Lee and Sohn successfully treated cardiogenic shock induced by a toxic dose of bupropion using lipid emulsion therapy, while Herrman et al managed a case of bupropion overdose complicated by cardiogenic shock through the combination of lipid emulsion therapy and vasopressor support [7][8] . Sirianni et al were among the first to report a compelling case of resuscitation using lipid emulsion therapy in a patient who experienced prolonged cardiovascular collapse following an overdose of bupropion and lamotrigine [9] .…”

Section: Case Presentationmentioning

confidence: 99%

Successful management of severe bupropion toxicity with lipid emulsion therapy: a complex case report and literature review

Eid,

Takla,

Eid

et al. 2023

European Journal of Case Reports in Internal Medicine

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This case report presents the management of a 53-year-old female with a complex psychiatric history who ingested multiple medications, resulting in severe cardiovascular compromise and subsequent respiratory failure. The patient’s ingestion included clonidine, fluoxetine, gabapentin, quetiapine and bupropion. Initial treatment involved supportive measures, including fluid resuscitation, bicarbonate infusion and correction of electrolyte imbalances. Despite these interventions, the patient remained haemodynamically unstable, requiring multiple vasopressors. Lipid emulsion therapy was initiated and led to a remarkable improvement in the patient’s cardiovascular status. However, she developed acute respiratory distress syndrome (ARDS) and required prolonged mechanical ventilation. Steroid therapy was initiated to manage the ARDS, and the patient was successfully extubated on day 6. The case highlights the potential effectiveness of lipid emulsion therapy in managing bupropion toxicity, but emphasises the need for further research to establish clear guidelines on dosing, timing and safety protocols. Adverse effects associated with lipid emulsion therapy must be carefully considered. Individualised decision-making and patient-centred care is crucial in optimising outcomes in cases of bupropion toxicity.

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