Serotonin syndrome is a serious and life-threatening reaction caused by excess serotonin in the CNS.
The classic triad
- Mental status changes (anxiety, restlessness, delirium, easy to startle)
- Autonomic hyperactivity (hyperthermia, hypertension, tachycardia, diaphoresis, vomiting, diarrhea)
- Neuromuscular abnormalities (hyperreflexia, myoclonus, tremor, muscle rigidity, and bilateral Babinski sign) – more pronounced in lower extremities
| Serotonin Syndrome | Neuroleptic Malignant Syndrome | |
| Onset | <24 H | Days to weeks (not |
| Neuromuscular | Hyperreactivity (tremor, clonus) | Severe muscle rigidity, hyporeactivity (bradyreflexia) |
| Cause | SSRIs, TCAs, MAOIs, other serotonergic drugs | Dopamine antagonists (antipsychotics) |
| Lab findings | None | Elevated CK |
| Treatment | STOP AGENT! Benzodiazepines +/- Propranolol | STOP AGENT! + Bromocriptine +/- Dantrolene |
| Resolution | Within 24h | Days to week |
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