# Postoperative Serotonin Syndrome Triggered by Propofol in a Patient on Chronic Serotonergic Medications and Bupropion: A Case Report

## TL;DR

A patient developed serotonin syndrome after receiving propofol during surgery while on other serotonergic medications, and recovered after treatment.

## Contribution

This case report highlights a rare instance of serotonin syndrome caused by propofol in a patient on chronic serotonergic drugs.

## Key findings

- A 34-year-old female developed serotonin syndrome after propofol administration during surgery.
- The patient recovered after treatment with benzodiazepines and cyproheptadine.
- Propofol is not commonly associated with serotonin syndrome, making this case unusual.

## Abstract

Serotonin syndrome is a potentially life-threatening condition that is commonly associated with the use of serotonergic agonistic medications, such as selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), and opioids. In contrast, propofol, a commonly used perioperative induction and intravenous sedation medication, is not frequently reported to cause serotonin syndrome. We present a rare case in a 34-year-old female who developed serotonin syndrome in the postoperative setting after the administration of propofol for induction and maintenance of anesthesia. The patient presented postoperatively with diaphoresis and non-fatigable ocular and extremity clonus, at which time she received benzodiazepines and cyproheptadine after discontinuing the offending agent. The patient successfully recovered from the condition following the administration of these medications.