Most books give bupropion a couple paragraphs, but it arguably deserves its own chapter. With a decrease in the use of tricyclics and increasing use of bupropion XR for depression, bupropion is becoming the most common cause of life-threatening antidepressant overdose. Bupropion has a uniquely dangerous property of blocking gap junctions between cardiomyocytes at high doses, an effect which may cause refractory cardiogenic shock. Combined with the sluggish pharmacokinetics of the extended release formulation (with the potential for delayed, ongoing absorption), this can create a prolonged struggle to keep these folks alive.
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The IBCC chapter is located here.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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