ABSTRACT
Bupropion has been in use for several decades. It is widely used for major depressive disorder (MDD), seasonal affective disorder (SAD), and smoking cessation. It is also a treatment of choice for mild-to-moderate depression and is prescribed for atypical and melancholic depression. However, bupropion overdose can lead to serious neurological and cardiovascular adverse effects. We report a recent case of bupropion overdose and review published cases in the literature to present the spectrum of clinical findings and treatments used to overcome the effects of bupropion overdose. Per our findings, bupropion doses of 2.7g and upward can lead to seizures and cause encephalopathy and cardiovascular effects. Higher doses could also lead to intubation and increased hospital stay. Therefore, patients with an increased risk of cardiovascular issues and seizures should be evaluated before starting the medication or increasing the dosage.
ABSTRACT
New-onset movement disorders have been frequently reported in association with the use of antiseizure medications (ASMs). The frequency of specific motor manifestations and the spectrum of their semiology for various ASMs have not been well characterized. We carried out a systematic review of literature and conducted a search on CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and Scopus from inception to April 2021. We compiled the data for all currently available ASMs using the conventional terminology of movement disorders. Among 5123 manuscripts identified by the search, 437 met the inclusion criteria. The largest number of reports of abnormal movements were in association with phenobarbital, valproic acid, lacosamide, and perampanel, and predominantly included tremor and ataxia. The majority of attempted interventions for all agents were discontinuation of the offending drug or dose reduction which led to the resolution of symptoms in most patients. Familiarity with the movement disorder phenomenology previously encountered in relation with specific ASMs facilitates early recognition of adverse effects and timely institution of targeted interventions.
