Clinical Pediatrics: Open Access
Open Access

Abstract

Atypical Antidepressant Toxidrome: A Case Report and a Proposed New Toxicity Syndrome

Hanna S. Sahhar*, Lauren Bailey and Erica Rubin

We report a case of intentional bupropion overdose in an adolescent female who presented with seizure, altered mental status, tachycardia, elevated anion gap, and hyperglycemia. Bupropion is an Atypical Anti-Depressant (AAD) that is typically used to treat major depressive disorder, seasonal affective disorder, and selective serotonin reuptake inhibitor-induced sexual dysfunction. Though there are documented cases of bupropion and other AAD overdose cases in pediatric literature with established presentations, AAD toxicity can still be challenging to recognize. Patients presenting with bupropion toxicity often require high level life sustaining care including airway stabilization and mechanical ventilation, vasopressor and inotropic support, and even extracorporeal membrane oxygenation, making early clinical identification of this toxicity especially important. AAD toxicity should be included in the toxicologic differential of patients with suspected overdose and symptoms including mydriasis, hypertension, tachycardia, or seizures. We propose a new AAD toxidrome to help healthcare providers more quickly identify the toxicity and better care for these patients.

Published Date: 2022-09-22; Received Date: 2022-08-22