A case of serotonin syndrome precipitated by fentanyl and ondansetron in a patient receiving paroxetine, duloxetine, and bupropion

摘要

Serotonin syndrome [1,2] is caused by stimulation of a subset of serotonin receptors in the brainstem and spinal cord. It may be a potentially life-threatening complication of exposure to multiple serotonergic medications (acting in different ways to increase serotonin levels) such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs) (Table 1). Other drugs implicated in this syndrome in the presence of SSRIs are analgesics, antibiotics, and anti-nausea and herbal medications (Table 2). We report a case of serotonin syndrome during general anesthesia in a patient requiring mastectomy.