{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:51:48Z","timestamp":1783644708759,"version":"3.55.0"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Adolescent depression and attempted and completed suicide are increasing in the United States. Because suicide is often impulsive, the means of self-harm are frequently items of convenience like medication. Authors of a recent study compared tricyclic antidepressant overdose to bupropion overdose. Fluoxetine and escitalopram are the only agents with Food and Drug Administration approval for pediatric depression, but off-label bupropion prescriptions are common. We sought to compare the effects of selective serotonin reuptake inhibitors (SSRIs) and bupropion in overdose.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>This was an analysis of the National Poison Data System from June 2013 through December 2017 for adolescent (ages 10\u201319) exposures to SSRIs or bupropion coded as \u201csuspected suicide.\u201d Demographics, clinical effects, therapies, and medical outcome were analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>There were 30\u2009026 cases during the study period. Sertraline and fluoxetine accounted for nearly 60%, whereas bupropion was reported in 11.7%. Bupropion exposure was significantly associated with death (0.23% vs 0%; P &amp;lt; .001) or serious outcome (58.1% vs 19%; P &amp;lt; .001) as well as the 10 most common clinical effects, including seizures (27.0% vs 8.5%; P &amp;lt; .001) and hallucinations (28.6% vs 4.3%; P &amp;lt; .001). Bupropion exposure was significantly associated with the need for cardiopulmonary resuscitation (0.51% vs 0.01%; P &amp;lt; .001), intubation (4.9% vs 0.3%; P &amp;lt; .001), vasopressors (1.1% vs 0.2%; P &amp;lt; .001), and benzodiazepines (34.2% vs 5.5%; P &amp;lt; .001). There was a significant increase in all exposures and in proportion of serious outcomes over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Adolescents who attempt self-harm are at higher risk for serious morbidity and poor outcomes with bupropion than with SSRIs. These risks, and the patient\u2019s propensity for self-harm, should be evaluated when therapy with bupropion is considered.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2018-3295","type":"journal-article","created":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T12:24:08Z","timestamp":1562329448000},"source":"Crossref","is-referenced-by-count":19,"title":["Toxicity of Bupropion Overdose Compared With Selective Serotonin Reuptake Inhibitors"],"prefix":"10.1542","volume":"144","author":[{"given":"Adam","family":"Overberg","sequence":"first","affiliation":[{"name":"Indiana Poison Center, Indianapolis, Indiana; and Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Morton","sequence":"additional","affiliation":[{"name":"Indiana Poison Center, Indianapolis, Indiana; and Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Wagner","sequence":"additional","affiliation":[{"name":"Emergency Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake","family":"Froberg","sequence":"additional","affiliation":[{"name":"Indiana Poison Center, Indianapolis, Indiana; and Departments of"},{"name":"Pediatrics, School of Medicine, Indiana University, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"issue":"10","key":"2021121101375917900_B1","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1080\/15563650.2017.1388087","article-title":"2016 annual report of the American Association of Poison Control Centers\u2019 National Poison Data System (NPDS): 34th annual report [published correction appears in Clin Toxicol (Phila). 2017;55(10):1256].","volume":"55","author":"Gummin","year":"2017","journal-title":"Clin Toxicol (Phila)"},{"issue":"9834","key":"2021121101375917900_B2","doi-asserted-by":"crossref","first-page":"2373","DOI":"10.1016\/S0140-6736(12)60322-5","article-title":"Self-harm and suicide in adolescents.","volume":"379","author":"Hawton","year":"2012","journal-title":"Lancet"},{"issue":"10","key":"2021121101375917900_B3","doi-asserted-by":"crossref","first-page":"962","DOI":"10.3109\/15563650.2015.1102927","article-title":"2014 annual report of the American Association of Poison Control Centers\u2019 National Poison Data System (NPDS): 32nd annual report [published correction appears in Clin Toxicol (Phila). 2016;54(7):607].","volume":"53","author":"Mowry","year":"2015","journal-title":"Clin Toxicol (Phila)"},{"issue":"4","key":"2021121101375917900_B4","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1007\/BF03161207","article-title":"Suicidal antidepressant overdoses: a comparative analysis by antidepressant type.","volume":"4","author":"White","year":"2008","journal-title":"J Med Toxicol"},{"issue":"8","key":"2021121101375917900_B5","doi-asserted-by":"crossref","first-page":"761","DOI":"10.3109\/15563650.2013.829233","article-title":"Drug-induced seizures in children and adolescents presenting for emergency care: current and emerging trends.","volume":"51","author":"Finkelstein","year":"2013","journal-title":"Clin Toxicol (Phila)"},{"issue":"6","key":"2021121101375917900_B6","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/S2215-0366(15)00170-4","article-title":"Long-term outcomes following self-poisoning in adolescents: a population-based cohort study.","volume":"2","author":"Finkelstein","year":"2015","journal-title":"Lancet Psychiatry"},{"issue":"2","key":"2021121101375917900_B7","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.jadohealth.2016.09.012","article-title":"Adolescent suicidal ingestion: national trends over a decade.","volume":"60","author":"Sheridan","year":"2017","journal-title":"J Adolesc Health"},{"issue":"5","key":"2021121101375917900_B8","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1080\/15563650.2017.1377839","article-title":"Suicidal bupropion ingestions in adolescents: increased morbidity compared with other antidepressants.","volume":"56","author":"Sheridan","year":"2018","journal-title":"Clin Toxicol (Phila)"},{"issue":"282","key":"2021121101375917900_B9","first-page":"1","article-title":"Drug overdose deaths among adolescents aged 15-19 in the United States: 1999-2015.","author":"Curtin","year":"2017","journal-title":"NCHS Data Brief"},{"issue":"23","key":"2021121101375917900_B10","doi-asserted-by":"crossref","first-page":"2343","DOI":"10.1056\/NEJMp078015","article-title":"Expanding the black box - 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