Bupropion
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Arrhythmia following in utero exposure: case report A fetus [sex not stated] developed cardiac arrhythmia following in utero exposure to bupropion. The fetus’s mother, a 29-year-old G2P1 woman, started receiving sertraline and cognitive behavioural therapy for major depression at 24 + 6 weeks gestation. At 30 weeks gestation, her sertraline was discontinued due to fatigue and headaches, and she started receiving bupropion 100mg daily [route not stated]. After 2 weeks, an irregular fetal heart rhythm was found during a routine prenatal examination. Additionally, the mother reported short episodes of contractions approximately 2–3 times a day and frequent fetal movements. A fetal heart trace was suggestive of premature atrial contractions. An echocardiogram, conducted on the following day, revealed that the fetus had occasional single premature atrial contractions with what appeared to be 1:1 atrioventricular conduction, without any major cardiac anomalies. Given the onset of arrhythmia immediately followed bupropion initiation, the possibility that bupropion had precipitated the arrhythmia was raised. Bupropion was discontinued and no further fetal arrhythmias were seen on a follow-up examination. The woman was treated with psychotherapy alone and her pregnancy continued without further complications. The baby was born with no evidence of arrhythmias or cardiac disease. Author comment: "The above case suggests a correlation between bupropion use during pregnancy and fetal cardiac arrhythmia: however, a casual relationship cannot be concluded." Leventhal K, et al. Fetal cardiac arrhythmia during bupropion use. Acta Obstetricia et Gynecologica Scandinavica 89: 980-981, No. 7, Jul 2010. Available from: URL: 803032735 http://dx.doi.org/10.3109/00016349.2010.485632 - USA
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Reactions 21 Aug 2010 No. 1315
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