Successful management of severe bupropion toxicity with lipid emulsion therapy: a complex case report and literature review
  • Fahad Eid
    Rochester Regional Health/Unity Hospital, Rochester, USA
  • Andrew Takla
    Rochester Regional Health/Unity Hospital, Rochester, USA
  • Mohamed Magdi Eid
    Rochester Regional Health/Unity Hospital, Rochester, USA
  • Mostafa Najim
    Rochester Regional Health/Unity Hospital, Rochester, USA
  • Mostafa Reda Mostafa
    Rochester Regional Health/Unity Hospital, Rochester, USA

Keywords

Bupropion toxicity, lipid emulsion therapy

Abstract

This case report presents the management of a 53-year-old female with a complex psychiatric history who ingested multiple medications, resulting in severe cardiovascular compromise and subsequent respiratory failure. The patient’s ingestion included clonidine, fluoxetine, gabapentin, quetiapine and bupropion. Initial treatment involved supportive measures, including fluid resuscitation, bicarbonate infusion and correction of electrolyte imbalances. Despite these interventions, the patient remained haemodynamically unstable, requiring multiple vasopressors. Lipid emulsion therapy was initiated and led to a remarkable improvement in the patient’s cardiovascular status. However, she developed acute respiratory distress syndrome (ARDS) and required prolonged mechanical ventilation. Steroid therapy was initiated to manage the ARDS, and the patient was successfully extubated on day 6. The case highlights the potential effectiveness of lipid emulsion therapy in managing bupropion toxicity, but emphasises the need for further research to establish clear guidelines on dosing, timing and safety protocols. Adverse effects associated with lipid emulsion therapy must be carefully considered. Individualised decision-making and patient-centred care is crucial in optimising outcomes in cases of bupropion toxicity.

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    Published: 2023-10-26
    Issue: 2023: Vol 10 No 12 (view)


    How to cite:
    1.
    Eid F, Takla A, Eid MM, Najim M, Mostafa MR. Successful management of severe bupropion toxicity with lipid emulsion therapy: a complex case report and literature review. EJCRIM 2023;10 doi:10.12890/2023_004025.

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