Category: Toxicology
Keywords: Bupropion, TCAs, adolescents (PubMed Search)
Posted: 12/20/2018 by Hong Kim, MD
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Selective serotonin reuptake inhibitors are the most common anti-depressant used today. However, the use bupropion in adolescents is increasing due the belief that it has fewer side effects than TCAs.
Using the National Poison Data System (2013 – 2016), the adverse effects of bupropion were compared to TCA in adolescents (13 – 19 years old) with a history of overdose (self harm).
Common clinical effects were:
TCA: n=1496; Bupropion: n=2257
| Clinical effects | TCAs | Bupropion |
| Tachycardia | 59.9% | 70.7% |
| Drowsiness/lethargy | 51.5% | 18.1% |
| Conduction disturbance | 22.2% | 15.6% |
| Agitation | 19.1% | 16.4% |
| Hallucination/delusions | 4.2% | 23.9% |
| Seizure | 3.9% | 30.7% |
| Vomiting | 2.7% | 20.0% |
| Tremor | 3.7% | 18.1% |
| Hypotension | 2.7% | 8.0% |
| Death | 0.3% | 0.3% |
Conclusion:
Bupropion overdose results in significant adverse effects in overdose; however, death is relatively rare.
Sheridan DC et al. Suicidal bupropion ingestions in adolescents: increased morbidity compared to other antidepressants. Clin Toxicol. 2018;56:360-364.
