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Case Report 


Single dose bupropion related acute dystonia: a case report

Süleyman Demir, Abdullah Atlı, Mehmet Güneş, Songül Çatı, Eşref Akıl, Nuralay Çetinkaya.

Cited by (2)

Abstract
Bupropion is an important pharmacologic agent similar to nicotine in the treatment of smoking cessation approved by Food and Drug Administration and European Union. Also, bupropion is an agent in the treatment of major depression as noradrenaline and dopamine reuptake inhibitor. In nicotine addiction, it is thought that it affects by blocking the dopamine reward pathway and decreasing the withdrawal symptoms related with noradrenaline pathway. We aimed to present a case with major depression and nicotine addiction developing acute dystonia with use of bupropion. Thirty-two year-old male, was diagnosed as having major depression and comorbid nicotine addiction. He did not have either another psychiatric problems or another medical disease and also he had not been using any kind of medicine. He was started to have 300 mg/day bupropion. The day after having first dose of 300 mg bupropion, he had some kind of pseudoesthesias, which caused sense of his neck being shorten, holding his tongue out of his mouth, not swallowing his saliva so he was taken to emergency. Evaluations and routine testing were observed normal ranges and there were not determined any pathologic issues out of acute dystonia during the neurologic examination. Clinical table showed that acute dystonia related to bupropion. His symptoms were getting better after he was given 5 mg biperiden as i.m. Finally, it was observed that there were not any dystonia symptoms after 24 hours of his check. Side effects of bupropion include insomnia, headache, dry mouth, eruption, nausea, excessive sweating, tinnitus and hypertension. Psychiatric problems including hypomania, acute psychosis, visual hallucinations and dystonia, hyponatremia, hypokalemia, and thrombotic thrombocytopenic purpura also reported as side effects of bupropion use in literature.

Key words: acute dystonia, bupropion, depression



Tek doz bupropiyon kullanımına bağlı akut distoni: Bir olgu sunumu

Ozet
Bupropiyon SR, sigara bırakma tedavisi için Food and Drug Administration ve Avrupa Birliği’nde onay almış nikotin dışı önemli bir farmakolojik seçenektir. Ayrıca majör depresyon tedavisinde kullanılan bupropiyon, noradrenalin ve dopamin geri alım inhibitörü olarak etki gösteren ajanlardan biridir. Tütün bağımlılığında dopamin ödüllendirme yolağını bloke ederek ve noradrenalin yolağına bağlı olarak ortaya çıkan yoksunluk belirtilerini azaltarak etki ettiği düşünülmektedir. Biz burada ilk doz bupropion SR aldıktan sonra akut distoni gelişen bir majör depresyon ve komorbid nikotin bağımlılığı olgusunu sunmayı amaçladık. Otuz iki yaşındaki erkek hastaya majör depresyon ve komorbid nikotin bağımlılığı tanısı konuldu. Hastada ek psikiyatrik ve psikiyatri dışı bir hastalık yoktu. Kullandığı herhangi bir ilaç yoktu. Hastaya bupropiyon 300 mg/gün başlandı. Hasta aldığı ilk doz 300 mg bupropiondan sonra boynunda kasılma hissi, dilini sürekli ağız dışında tutma ve tükürüğünü yutamama yakınmalarıyla acil servise başvurdu. Rutin laboratuvar testleri normal bulundu ve nörolojik muayenede akut distoni dışında bir patolojik bulgu saptanmadı. Klinik tablo bupropiyona bağlı akut distoni olarak değerlendirildi. Hastaya 5 mg biperiden i.m. yapıldı ve belirtiler düzeldi. Hastanın 24 saat sonraki muayenesinde distoni belirtileri yoktu. Bupropiyon kullanımında görülen yan etkiler uykusuzluk, baş ağrısı ve ağız kuruluğu, döküntü, bulantı, uykusuzluk, aşırı terleme, kulak çınlaması, hipertansiyon şeklinde sıralanabilir. Bupropiyonla ilişkili olarak literatürde hipomani, akut psikoz, görsel varsanı gibi psikiyatrik tablolarla beraber distoni, hiponatremi, hipokalemi, trombotik trombositopenik purpura gibi bazı farklı psikiyatri dışı genel tıbbi tablolar bildirilmiştir.

Anahtar Kelimeler: Akut distoni, bupropiyon, depresyon


 
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How to Cite this Article
Pubmed Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya. [Single dose bupropion related acute dystonia: a case report]. Anadolu Psikiyatri Derg. 2015; 16(3): 227-229. Turkish. doi:10.5455/apd.167086


Web Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya. [Single dose bupropion related acute dystonia: a case report]. http://www.anadolupsikiyatri.net/?mno=167086 [Access: November 13, 2018]. Turkish. doi:10.5455/apd.167086


AMA (American Medical Association) Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya. [Single dose bupropion related acute dystonia: a case report]. Anadolu Psikiyatri Derg. 2015; 16(3): 227-229. Turkish. doi:10.5455/apd.167086



Vancouver/ICMJE Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya. [Single dose bupropion related acute dystonia: a case report]. Anadolu Psikiyatri Derg. (2015), [cited November 13, 2018]; 16(3): 227-229. Turkish. doi:10.5455/apd.167086



Harvard Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya (2015) [Single dose bupropion related acute dystonia: a case report]. Anadolu Psikiyatri Derg, 16 (3), 227-229. Turkish. doi:10.5455/apd.167086



Turabian Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya. 2015. [Single dose bupropion related acute dystonia: a case report]. Anatolian Journal of Psychiatry, 16 (3), 227-229. Turkish. doi:10.5455/apd.167086



Chicago Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya. "[Single dose bupropion related acute dystonia: a case report]." Anatolian Journal of Psychiatry 16 (2015), 227-229. Turkish. doi:10.5455/apd.167086



MLA (The Modern Language Association) Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya. "[Single dose bupropion related acute dystonia: a case report]." Anatolian Journal of Psychiatry 16.3 (2015), 227-229. Print.Turkish. doi:10.5455/apd.167086



APA (American Psychological Association) Style

Suleyman Demir, Abdullah Atli, Mehmet Gunes, Songul Cati, Esref Akil, Nuralay Cetinkaya (2015) [Single dose bupropion related acute dystonia: a case report]. Anatolian Journal of Psychiatry, 16 (3), 227-229. Turkish. doi:10.5455/apd.167086





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