Fatal bupropion overdose with post mortem blood concentrations

  • Henry A. SpillerEmail author
  • Edward Bottei
  • Linda Kalin
Case Report


We report five cases of fatal bupropion overdose with post mortem bupropion concentrations ranging from 3.1 to >20 mg/L. Four patients had ingested a sustained-release formulation of bupropion and had evidence of pill “bodies” in their stomach with significantly elevated blood bupropion concentrations. The pills found in these patients may represent the residual matrix/shell with significant portions of the actual bupropion released and absorbed by the patients.


Bupropion Overdose Postmortem Fatal Sustained-release formulation Forensic toxicology 


  1. 1.
    Belson MG, Kelly TR. Bupropion exposures: clinical manifestations and medical outcome. J Emerg Med 2002;23:223–230.PubMedCrossRefGoogle Scholar
  2. 2.
    Shepherd G, Valez LI, Keyes DC. Intentional bupropion overdoses. J Emerg Med 2004;27:147–151.PubMedCrossRefGoogle Scholar
  3. 3.
    Balit CR, Lynch CN, Isbister GK. Bupropion poisoning: a case series. Med J Aust 2003;178:61–63.PubMedGoogle Scholar
  4. 4.
    Spiller HA, Ramoska EA, Krenzelok EP, Sheen SR, Borys DJ, Villalobos D, Muir S, Jones-Easom L. Bupropion overdose: a 3-year multi-center retrospective analysis. Am J Emerg Med 1994;12:43–45.PubMedCrossRefGoogle Scholar
  5. 5.
    Rohrig TP, Ray NG. Tissue distribution of bupropion in fatal overdose. J Anal Toxicol 1992;16:343–345.PubMedGoogle Scholar
  6. 6.
    Friel PN, Logan BK, Filgner CL. Three fatal drug overdoses involving bupropion. J Anal Toxicol 1993;17:436–438.PubMedGoogle Scholar
  7. 7.
    Ramcharitar V, Levine BS, Goldberger BA, Caplan YH. Bupropion and alcohol fatal intoxication: case report. Forensic Sci Int 1992;56:151–156.PubMedCrossRefGoogle Scholar
  8. 8.
    Shrier M, Diaz JE, Tsarouhas N. Cardiotoxicity associated with bupropion overdose. Ann Emerg Med 2000;35:100.PubMedGoogle Scholar
  9. 9.
    Isbister GK, Balit CR. Bupropion overdose: QTc prolongation and its clinical significance. Ann Pharmacother 2003;37:999–1002.PubMedCrossRefGoogle Scholar
  10. 10.
    Curry SC, Kashanl JS, LoVecchio F, Holubek W. Intraventricular conduction delay after bupropion overdose. J Emerg Med 2005; 29:299–305.PubMedCrossRefGoogle Scholar
  11. 11.
    Harris CR, Gualtieri J, Stark G. Fatal bupropion overdose. J Toxicol Clin Toxicol 1997;35:321–324.PubMedCrossRefGoogle Scholar
  12. 12.
    Jepsen F, Mathews J, Andrews FJ. Sustained release bupropion overdose: an important cause of prolonged symptoms after overdose. Emerg Med J 2003;20:560–561.PubMedCrossRefGoogle Scholar
  13. 13.
    Anderson DT, Fritz KL, Muto JJ. Oxycontin: the concept of a “ghost pill” and the postmortem tissue distribution of oxycodone in 36 cases. J Anal Toxicol 2002;26:448–459.PubMedGoogle Scholar
  14. 14.
    Wellbutrin XL. In: Physicians’ Desk Reference, vol 60. Thompson PDR, Montvale, NJ, 2006, pp 1588–1593.Google Scholar
  15. 15.
    Reynolds GP, Elsworth JD, Blau K, Sandler M, Lees AJ, Stern GM. Deprenyl is metabolized to methamphetamine and amphetamine in man. Br J Clin Pharmacol 1978;6:542–544.PubMedGoogle Scholar

Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  1. 1.Kentucky Regional Poison CenterLouisvilleUSA
  2. 2.Iowa Statewide Poison Control CenterSioux CityUSA

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