Delayed status epilepticus due to bupropion and lamotrigine overdose

Year 2013, Volume: 18 Issue: 3, 142 - 144, 02.10.2013

Nitin K. Sethi Philippe Douyon Ulrike Kaunzner Prahlad K. Sethi Josh Torgovnick Frances Cukierwar Justin Marcus

Abstract

Bupropion is a well known atypical antidepressant marketed in the United States under the trade name Wellbutrin. In its sustained release form, it is also used for smoking cessation. It lowers seizure threshold and its potential to cause seizures has been widely publicized. Lamotrigine is a broad spectrum anticonvulsant with an extremely favorable side-effect profile and has thus rapidly become the preferred drug for a broad range of seizure types such as absence seizures, primary generalized epilepsy syndromes such as idiopathic generalized tonic-clonic seizures, juvenile myoclonic epilepsy as well as partial (focal) epilepsy. It is also used by psychiatrists as a mood stabilizer. We report a patient who presented with delayed status epilepticus following a failed suicidal attempt after overdosing on bupropion XL and lamotrigine.

Keywords

Bupropion overdose, lamotrigine overdose, suicide, status epilepticus

References

• French LK, McKeown NJ, Hendrickson RG. Complete heart block and death following lamotrigine overdose. Clin Toxicol (Phila) 2011; 49: 330-333.
• Herold TJ. Lamotrigine as a possible cause of QRS prolongation in a patient with known seizure disorder. CJEM 2006; 8: 361-364.
• Barczyński B, Buszewicz G, Łuszczki JJ, et al. Low dose of bupropion significantly enhances the anticonvulsant activity of felbamate, lamotrigine and topiramate in mice. Eur J Pharmacol 2011; 650: 5505
• Odishaw J, Chen C. Effects of steady-state bupropion on the pharmacokinetics of lamotrigine in healthy subjects. Pharmacotherapy 2000; 20: 1448-1453. Sirianni AJ, Osterhoudt KC, Calello DP, et al. Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Ann Emerg Med 2008; 51: 412-4