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Cardiotoxicity associated with intentional ziprasidone and bupropion overdose
Abhik K Biswas1, Luke A Zabrocki, Kendra L Mayes
1Pediatric Critical Care Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia 23708, USA. akbiswas@mar.med.navy.mil
Journal of Toxicology. Clinical Toxicology
|March 21, 2003
Summary
Ziprasidone and bupropion overdose can cause serious heart rhythm problems, requiring extended monitoring and treatment. This case highlights potential cardiotoxicity even with seemingly safe cardiac profiles.
Area of Science:
- Pharmacology
- Cardiology
- Toxicology
Background:
- Ziprasidone (Geodon) and bupropion (Wellbutrin) are commonly prescribed for mood and behavioral disorders.
- These medications are generally considered to have safe cardiac profiles at therapeutic and supra-therapeutic doses.
Observation:
- A 17-year-old male experienced significant cardiac abnormalities after ingesting both ziprasidone and bupropion.
- The patient developed a widened QRS complex and a prolonged QTc interval.
Findings:
- The overdose necessitated hospital admission for intensive cardiac monitoring and antidysrhythmic therapy.
- Cardiac parameters returned to baseline approximately 80 hours post-ingestion, indicating a prolonged recovery period.
Implications:
- This case underscores the potential for significant cardiotoxicity associated with combined ziprasidone and bupropion ingestion.
- Clinicians should be aware of the risk of delayed cardiac complications and the need for prolonged monitoring and management in such overdose scenarios.