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Factors associated with seizure development after bupropion overdose: a review of the toxicology investigators consortium.
- Source :
-
Clinical toxicology (Philadelphia, Pa.) [Clin Toxicol (Phila)] 2021 Dec; Vol. 59 (12), pp. 1234-1238. Date of Electronic Publication: 2021 Apr 21. - Publication Year :
- 2021
-
Abstract
- 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.<br />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.<br />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.<br />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.
Details
- Language :
- English
- ISSN :
- 1556-9519
- Volume :
- 59
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Clinical toxicology (Philadelphia, Pa.)
- Publication Type :
- Academic Journal
- Accession number :
- 33878992
- Full Text :
- https://doi.org/10.1080/15563650.2021.1913180