Severe Bupropion Intoxication Successfully Treated with Resin Adsorber Haemoperfusion

Bupropion is used as smoking cessation drug and antidepressant. Drug overdose has multi-system involvement including neurotoxicity and cardiovascular collapse. Use of haemoperfusion in bupropion toxicity is generally not useful, however in life-threatening condition it could be a life saver. We reported a case of 30s male with bupropion overdose who ingested 29 tablets of 300-mg extended-release bupropion. The patient had status epilepticus with prolonged QTc interval. He remained unconscious with abnormal jerky movements despite multiple high dose antiepileptic drugs. A 4-h session of resin adsorber haemoperfusion was done with rapid improvement of consciousness within 24 h and seizure control confirmed by electroencephalogram. In severe cases with early presentation, haemoperfusion may be useful to prevent further toxicity.