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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
|May 8, 2003
Summary
Ziprasidone and bupropion overdose can cause dangerous heart rhythm changes. This case highlights the need for extended cardiac monitoring and treatment after ingesting these medications.
Area of Science:
- Pharmacology
- Cardiology
- Toxicology
Background:
- Ziprasidone and bupropion are commonly prescribed for mood and behavioral disorders.
- Both medications are generally considered to have safe cardiac profiles.
- The FDA has cautioned about ziprasidone's potential to prolong the QTc interval, especially with other QTc-prolonging drugs.
Observation:
- A 17-year-old male experienced a widened QRS complex and prolonged QTc interval after an overdose of ziprasidone and bupropion.
- The patient required intensive cardiac monitoring and antidysrhythmic treatment in a hospital setting.
Findings:
- The combined ingestion of ziprasidone and bupropion led to significant cardiotoxicity, evidenced by QRS widening and QTc prolongation.
- Cardiac parameters normalized approximately 80 hours after ingestion, indicating a prolonged recovery period.
Implications:
- This case underscores the potential cardiotoxic effects of ziprasidone and bupropion, even when previously considered safe.
- Clinicians should be aware of the risk of significant cardiac events following overdose of these medications.
- Extended monitoring and aggressive treatment may be necessary for patients presenting with cardiotoxicity from ziprasidone and bupropion ingestion.