The effect of propofol on mental health in Saudi Arabia

Propofol is a widely used intravenous anesthetic agent with a rapid onset and short duration of action. While extensively utilized for sedation and anesthesia, recent research has raised concerns regarding its impact on mental health, particularly addiction potential, hormonal effects, and neuropsychiatric implications in individuals with underlying neurological conditions. This review aims to examine the neurobiological, hormonal, and psychiatric effects of propofol with a focus on addiction mechanisms, its role in neurodevelopmental and neurodegenerative syndromes, and its modulation of stress- and mood-related hormones, especially within the healthcare landscape of Saudi Arabia. A comprehensive literature review was conducted, drawing from experimental studies, clinical trials, and pharmacological analyses that explored propofol’s interaction with dopamine pathways, hormone regulation, and its implications in syndromes such as Down syndrome, fragile X syndrome (FXS), and Tourette syndrome (TS). Propofol’s interaction with the mesolimbic dopamine system and dopamine transporter (DAT) contributes to its addictive properties. It alters hormonal responses by modulating GABAergic pathways, reducing stress hormone levels such as cortisol and epinephrine. In patients with specific syndromes, propofol demonstrates differential effects on cognition, recovery, and neurological activity, requiring tailored clinical considerations. While propofol remains a cornerstone of modern anesthesia, its psychoactive and addictive potential, especially among healthcare professionals, necessitates stricter regulation and education. Its impact on stress modulation and mental health highlights its dual therapeutic promise and risk, warranting further clinical research and policy development, particularly in Saudi Arabia, where regulatory oversight remains limited.