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- C William Heise, Aaron B Skolnik, Robert A Raschke, Huw Owen-Reece, and Kimberlie A Graeme.
- Center for Toxicology and Pharmacology Education and Research, University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA. craig.heise@bannerhealth.com.
- J Med Toxicol. 2016 Sep 1; 12 (3): 301-4.
AbstractBupropion inhibits the uptake of dopamine and norepinephrine. Clinical effects in overdose include seizure, status epilepticus, tachycardia, arrhythmias, and cardiogenic shock. We report two cases of severe bupropion toxicity resulting in refractory cardiogenic shock, cardiac arrest, and repeated seizures treated successfully. Patients with cardiovascular failure related to poisoning may particularly benefit from extracorporeal membrane oxygenation (ECMO). These are the first cases of bupropion toxicity treated with veno-arterial EMCO (VA-ECMO) in which bupropion toxicity is supported by confirmatory testing. Both cases demonstrate the effectiveness of VA-ECMO in poisoned patients with severe cardiogenic shock or cardiopulmonary failure.
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