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Bupropion: Toxicity & Side Effects

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Bupropion is a medication used for depression, but is also used for smoking cessation. This lesson will discuss the side effects and toxicity symptoms of bupropion.

Too Many Pills

Tim is taking bupropion to help him quit smoking. Since this medication affects the pleasure centers of the brain, it makes Tim feel good. He took several extra bupropion pills in the hopes of increasing the positive feelings he has. He is starting to have some abnormal symptoms and decides to go the emergency room.

Bupropion

Bupropion is an antidepressant medication that is also used as an aid to quit smoking. It helps regulate the neurotransmitters serotonin, dopamine, and norepinephrine in the brain. Serotonin regulates anxiety, well-being, and mood. Dopamine regulates emotional responses and movement. Norepinephrine controls the fight or flight response, and promotes alertness, memory retrieval, and focus. Generally, this medication improves mood and feelings of well-being.

Tim has been taking bupropion for about a month now and has not smoked for three weeks. Even though Tim is taking bupropion to quit smoking, he still gets the effects of improved mood. The exact function of bupropion for smoking cessation is unknown, but it is thought to help reduce cravings and withdrawal symptoms. Tim has noticed that he has reduced cravings, less irritability and anxiety, better concentration, and decreased feelings of depression. Unfortunately he has taken more medication than prescribed and is showing increased side effects from the medication.

Side Effects of Bupropion

Common side effects of bupropion include:

  • Inability to focus
  • Strange dreams
  • Dry mouth
  • Dizziness
  • Agitation
  • Constipation
  • Diarrhea
  • Insomnia
  • Headache
  • Nausea
  • Excessive sweating
  • Pounding heart
  • Weight loss
  • Abdominal pain

Side effect of bupropion: abdominal pain
Side effect of bupropion: abdominal pain

When first starting to take bupropion there may be an increase in suicidal thoughts or risk of having a seizure, especially if there is a history of seizures.

Tim is having trouble focusing, dry mouth, dizziness, a pounding heart, and headache since taking too much bupropion. His pills are extended release so he is still at a risk of showing bupropion toxicity. The nurses in the emergency room are familiarizing themselves with toxicity symptoms that Tim might experience.

Bupropion Toxicity

Signs and symptoms of bupropion toxicity include:

  • Seizures
  • Agitation
  • Slurred speech
  • Hallucinations
  • Vomiting
  • Low potassium
  • Fatigue
  • Coma
  • Tremors
  • Increased heart rate
  • Increased QRS complex (monitored on EKG)

Example of a QRS complex
Example of a QRS complex

Since Tim's bupropion is extended release, he is at risk for developing signs of toxicity up to twenty-four hours after ingestion. Therefore, he is kept at the hospital for observation. During his stay, Tim developed some slurred speech, hallucinations, tremors, and an increased QRS complex. He also had a seizure approximately twelve hours after he was admitted to the hospital.

Treatment of Bupropion Toxicity

When Tim first came to the emergency room the doctor tried to induce vomiting in order to decrease the amount of medication in his system. Treatment for bupropion toxicity is considered supportive. This means that the specific signs and symptoms are treated. Tim received the following treatments:

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