Objective: To determine whether bupropion overdose has been associated with cardiovascular toxicity.
Data sources: MEDLINE (1966-January 2002), EMBASE (1980-January 2002), Current Contents (January 2002), and PubMed (January 2002) databases for English-language human reports. Search terms included bupropion, overdose (drug), intoxication, poisoning, and acute ingestion.
Data synthesis: Articles describing toxicity following bupropion overdose were evaluated independently by both authors to identify cases of cardiotoxicity.
Results: Thirteen articles describing bupropion overdose in 116 patients were identified. Only 3 patients exhibited cardiotoxicity following acute ingestion; 2 of these patients also ingested other medications. All 3 patients experienced tachycardia and conduction delays (widened QRS complex and/or prolonged QTc interval), but none of these delays progressed to a life-threatening arrhythmia. All patients recovered, with resolution of cardiotoxicity within 2-4 days following ingestion.
Conclusions: We recommend that all patients with an overdose of bupropion should have an electrocardiogram performed on admission and should be monitored for the development of conduction delays and/or life-threatening arrhythmias.