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Seizures induced by recreational abuse of bupropion tablets via nasal insufflation

Published online by Cambridge University Press:  21 May 2015

Daniel Kim  and
Brian Steinhart
Daniel Kim*
Affiliation:
Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ont.
Brian Steinhart
Affiliation:
Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ont. Department of Emergency Medicine, St. Michael's Hospital, Toronto, Ont.
*
1912–633 Bay St, Toronto ON M5G 2G4; dkim000@gmail.com

Abstract

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Bupropion is a newer generation antidepressant that is commonly used for treatment of depression and for smoking cessation. Seizures are a frequently reported adverse effect of bupropion in therapeutic oral doses; however, there are limited data about the consequences of nasal insufflation of bupropion. We report the case of a patient who presented to the emergency department (ED) with a recent history of generalized tonic–clonic seizures whose etiology was initially a diagnostic mystery. After an initial visit to another ED, the patient presented to our ED later that day with a recurrence of the seizures after crushing and nasally insufflating oral bupropion tablets. We review important implications of this case to emergency medicine, including the potential for abuse of bupropion, the difference between intranasal and oral administration, the changing trends in the etiology of drug-related seizures and the importance of examining the nares in patients with unexplained seizure and delirium.

Keywords

bupropionseizurenasal insufflationnares
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 12 , Issue 2 , March 2010 , pp. 158 - 161
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

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