Cardiotoxicity associated with intentional ziprasidone and bupropion overdose.
BACKGROUND
Ziprasidone and bupropion are medications prescribed for mood and behavior disorders. They have apparently safe cardiac safety profiles in both therapeutic and supratherapeutic doses, but recently the Federal Drug Administration has issued a caution regarding ziprasidone use in combination with other drugs that are known to prolong the QTc interval.


METHODS
A 17-year-old male developed a widened QRS and a prolonged QTc interval following an overdose of ziprasidone and bupropion. He required hospital admission for aggressive cardiac monitoring and antidysrhythmic therapy, stabilizing to baseline by 80 hours postingestion.


CONCLUSIONS
We present a case that underscores the potential cardiotoxicities of these medications. Ziprasidone and bupropion ingestion can be associated with cardiotoxicities that may require several days of aggressive cardiac monitoring and treatment.
Pediatric Critical Care Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia 23708, USA. akbiswas@mar.med.navy.mil
Abhik K
AK
Biswas
Luke A
LA
Zabrocki
Kendra L
KL
Mayes
Cynthia L
CL
Morris-Kukoski
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000506:poisoning*; D014150:Antipsychotic Agents / Q000506:poisoning*; D016642:Bupropion / Q000506:poisoning*; D003243:Consciousness / Q000187:drug effects; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology; D062787:Drug Overdose; D004562:Electrocardiography / Q000187:drug effects; D006331:Heart Diseases / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008012:Lidocaine / Q000627:therapeutic use; D008133:Long QT Syndrome / Q000139:chemically induced / Q000188:drug therapy; D008297:Male; D010879:Piperazines / Q000506:poisoning*; D013406:Suicide, Attempted; D013844:Thiazoles / Q000506:poisoning*
D000889:Anti-Arrhythmia Agents; D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; D016642:Bupropion; C092292:ziprasidone; D008012:Lidocaine