Psychiatry and Clinical Psychopharmacology

Supraventricular tachycardia developed after suicide attempt with extended release form of bupropion: a case report

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S191-S192
Read: 749 Published: 18 February 2021

A case of supraventricular tachycardia, which was developed after suicidal attempt with extended release form of bupropion, will be discussed in this report. A 28 year old female patient was admitted to hospital with complaints such as fatigue, reluctance, malaise and excessive sleepiness request starting about 4 months ago. With the initial diagnosis of major depressive disorder 150 mg/g of extended-release bupropion treatment was started 4 months ago. The patient was brought to the emergency room following a failed suicide attempt with 25 pills containing extended release form of bupropion. In her medical history there was not any history of organic or psychiatric disease and she was not receiving any other medical treatment. Her family told that she never had a suicide attempt and also her symptoms were partially improved after starting the treatment with bupropion 4 months ago. It was noted that the suicidal attempt occurred after an impulsive family stressor. The patient was oriented, cooperative and conscious on admission. On physical examination her blood pressure was around 90/60 mmHg with a pulse rate 170 beats/min. The biochemistry, complete blood count, urinalysis results were in normal limits. After starting her initial medical treatment with a diagnosis of drug intoxication we performed a mental status examination to assess patient’s behavioral and cognitive functions. Her mental status examination revealed that she was establishing eye contact, a good self-care and she was cooperated. The spontaneity of speech and intonation was decreased. Her affect was depressive and anxious. She was having sense of regret about her suicidal attempt. There were no perception and memory deficits. At the same time the electrocardiogram (ECG) of patient was taken because of rapid heart rate. We have observed supraventricular tachycardia with a ventricular rate of 169/min on her ECG. The patient was evaluated by a cardiologist and successfully converted to sinus rhythm after administration of adenosine. On her bedside echocardiography, no structural heart disease that can lead to supraventricular tachycardia was observed. Her hemodynamic parameters were normalized and she was admitted to psychiatry clinic for follow up. Several cases of extended release form of bupropion overdose with ventricular tachycardia, sinus tachycardia or other kind of arrhythmias have been reported in the literature. In our case we wanted to report a case of supraventricular tachycardia after intake of high doses of bupropion for suicide attempt, despite the 4 months use of extended release form of bupropion without any side effects,

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