Overview
Burpropion is used as an antidepressant, smoking cessation aid, and dieting
It is the only synthetic cathinone (i.e. bath salt) approved by FDA
Chemical structure similar to methamphetamine
Inhibits reuptake of dopamine and norepinephrine = cocaine-like effects, but with less intensity
Antagonizes acetylcholine at neuronal nicotinic receptors
Crushing and Insufflation or snorting bupropion can cause tachycardia, euphoria, agitation, hallucinations, and seizures
Case reports from Canada about IV injection as well.
Overdose
A 2014 review of 11 years of California Poison Control Data reveals the most common serious symptom of overdose is seizure – occurring in 30% of patients in the study. There were total of 74 cases over this time period.
Lowers seizure threshold even at therapeutic doses
Potential cardiotoxicity from overdose: sinus tachycardia -> wide QRS, ventricular dysrhythmias and cardiovascular collapse
Management
ECG recommended
Consider bupropion in new onset seizures of unknown cause, particularly if SUD suspected.
Lipid emulsion may be helpful in life threatening cardiovascular toxicity
Supportive care for seizures
References
1. Lewis JC, Sutter ME, Albertson TE, Owen KP, Ford JB. An 11-year review of bupropion insufflation exposures in adults reported to the California Poison Control System. Clin Toxicol (Phila). 2014;52(9):969-972. doi:10.3109/15563650.2014.969372
2. Stall N, Godwin J, Juurlink D. Bupropion abuse and overdose. CMAJ. 2014;186(13):1015. doi:10.1503/cmaj.131534
3. Focus on bupropion toxicity and abuse. Accessed February 25, 2026. http://www.dpic.org/article/professional/focus-bupropion-toxicity-and-abuse