Journal of Medical Toxicology

, Volume 12, Issue 3, pp 301–304 | Cite as

Two Cases of Refractory Cardiogenic Shock Secondary to Bupropion Successfully Treated with Veno-Arterial Extracorporeal Membrane Oxygenation

  • C. William HeiseEmail author
  • Aaron B. Skolnik
  • Robert A. Raschke
  • Huw Owen-Reece
  • Kimberlie A. Graeme
Toxicology Observation


Bupropion inhibits the uptake of dopamine and norepinephrine. Clinical effects in overdose include seizure, status epilepticus, tachycardia, arrhythmias, and cardiogenic shock. We report two cases of severe bupropion toxicity resulting in refractory cardiogenic shock, cardiac arrest, and repeated seizures treated successfully. Patients with cardiovascular failure related to poisoning may particularly benefit from extracorporeal membrane oxygenation (ECMO). These are the first cases of bupropion toxicity treated with veno-arterial EMCO (VA-ECMO) in which bupropion toxicity is supported by confirmatory testing. Both cases demonstrate the effectiveness of VA-ECMO in poisoned patients with severe cardiogenic shock or cardiopulmonary failure.


ECMO Cardiogenic shock Overdose Bupropion Extracorporeal membrane oxygenation Status epilepticus 


Compliance with Ethical Standards

Conflicts of Interest

All authors have no conflicts of interest nor financial stake to disclose.

Informed Consent

Consent for publication of these cases was obtained and provided to the journal in accordance with JMT policy.

Sources of Funding



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Copyright information

© American College of Medical Toxicology 2016

Authors and Affiliations

  • C. William Heise
    • 1
    • 2
    Email author
  • Aaron B. Skolnik
    • 2
  • Robert A. Raschke
    • 3
  • Huw Owen-Reece
    • 3
  • Kimberlie A. Graeme
    • 2
  1. 1.Center for Toxicology and Pharmacology Education and ResearchUniversity of Arizona College of Medicine PhoenixPhoenixUSA
  2. 2.Department of Medical ToxicologyBanner University Medical Center PhoenixPhoenixUSA
  3. 3.Department of Medicine, Section of Critical CareBanner University Medical Center PhoenixPhoenixUSA

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