Mini Episode: Who Seizes in Bupropion Overdose with Dr Ari Filip MD

Seizure Risk: Patients can seize 8–24 hours post-ingestion. Neurologic symptoms and tachycardia often precede seizures.Delayed Symptoms: Co-ingestions may mask tachycardia, and symptoms can be significantly delayed.Key Management Advice:Do not discharge patients without consulting a toxicologist or poison center about observation times.Do not dismiss tachycardia and anxiety as situational in cases of bupropion overdose.Key StudiesSpiller 1994: Review of instant-release bupropion overdoses.Shepherd 2004: Seizures predominantly occur with sustained-release products. Most cases had prodromal neuropsychiatric symptoms.Starr 2009: Analysis of XL products:Symptoms predicting seizures: Tachycardia, tremor, and agitation.Tachycardia may be masked by coingestions and symptoms may be very delayedSeizures occurred as late as 24 hours, with 25% occurring after 8 hours.Offerman 2020: Study of sustained/extended-release products:Tachycardia (duration and rate >120 bpm) predicts seizures.Hypotension and neuropsychiatric symptoms also predictive.Prehospital seizures associated with cardiac arrest—indicative of poor outcomes.Rianprakaisang 2021: ToxIC database review of seizure risk factors:QTc prolongation and HR >140 bpm are predictive of seizures.A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)Reach the showEmail: [email protected] Show ResourcesRyan's Medical Games and ResourcesShow Website