Daniel Greer, Justina Girgis, John Kashani, Jennifer Atherton
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Abstract
Dextromethorphan and bupropion in combination are approved to treat major depressive disorders in adults. This case report describes a patient with a history of treatment-resistant depression who presented to the emergency department after overdosing on approximately 30 tablets of dextromethorphan-bupropion 45-105 mg in a suicide attempt. The patient required intubation, gastrointestinal decontamination, and changes in her antidepressant medications. The patient reported no suicidality by the end of her hospitalization, and she was discharged on paroxetine 40 mg daily and quetiapine 200 mg at night. Clinicians should be cautious and vigilant when prescribing or considering these medications together, particularly in populations at risk of overdose.
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