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A case of bupropion-induced
seizure.
Sheehan DV, Welch JB, Fishman
SM.
Bupropion is a novel new antidepressant without the
undesirable anticholinergic, cardiotoxic, sedative, or sexual side
effects of other available antidepressants. However, like many other
antidepressants, there is a small risk that patients on bupropion may
develop a seizure even at moderate doses and moderate blood levels and
even in the absence of any premorbid history or other predisposing
factors to epilepsy. The report presents the case of a 25-year-old woman
with a 12-year history of agoraphobia and panic attacks treated with
bupropion in a research protocol. She was in good physical health, with
normal physical and neurological examination, and normal complete blood
count, serum mineral analysis-12, and urinalysis laboratory values. She
had no premorbid history of epilepsy or neurological illness, nor any
other known predisposing factors to epilepsy. On day 28 of the study,
immediately after her dose of bupropion was increased from 450 to 600
mg/day, she had a generalized convulsion with tonic and clonic phases,
loss of consciousness, and postictal confusion that was reliably
witnessed by several observers. The EEG abnormality had cleared 15 days
later. Further EEGs after 4 weeks and 10 weeks were normal. Five years
later she remains seizure-free, off all antiseizure medication, and
without any further complications from this incident. This seizure
occurred at a modest blood level of bupropion (83 ng/ml) and at a dose
not considered excessive (600 mg/day). Other confounding organic and
neurological illness or use of other medication was carefully and
systematically ruled out, leaving the bupropion as the most likely
explanation for her seizure.(ABSTRACT TRUNCATED AT 250
WORDS)
Publication Types:
PMID: 3090199 [PubMed - indexed for
MEDLINE]
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