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A 43-year-old man with a history of depression and posttraumatic stress disorder (PTSD) developed serotonin syndrome during treatment with bupropion [amfebutamone; duration of treatment not stated] and dextromethorphan [therapeutic indications not clearly stated; dosages not stated; time to reaction onset not clearly stated].
The man, who was receiving once-daily bupropion [Wellbutrin] at an unknown dose, underwent extraction of his left molar, as well as incision and drainage near the first molar due to a submandibular space infection; prior to the procedure, his BP and heart rate (HR) were 132/84mm Hg and 75 beats/min, respectively. He also not been eating well or taking in fluids for the previous 3-4 days due to mild dysphagia and feeling unwell. He received lidocaine and epinephrine [adrenaline] around the left mandibular first molar and his tooth was extracted. IV lactated Ringer's solution and clindamycin were given. About 30 minutes after the procedure (after the IV infusion was completed), he developed an acute onset of mild confusion and restlessness, and...