serotonin syndrome Vs NMS

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Dr.serotonin

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plz through some light on differentiating neuroleptic malignant syndrome and serotonin syndrome.

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Serotonin syndrome: agitation, confusion, fever diarrhea, tremor, hyperreflexia

NMS: confusion, disorientation, muscle rigidity, fever, rhabdomyolysis.

So the diarrhea and hyperreflexia are key distinguishers of serotonin syndrome and then the muscle rigidity and lysis are key for the NMS (you can order a CK). Those are the key contrasts IMO. Also the drugs that cause them of course


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NMS = slow onset, muscle rigidity, hyporeflexia, inc CK
SS = fast onset, myoclonus, hyperreflexia, mydriasis, diarrhea
 
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Also, in serotonin syndrome the symptoms keep flipping between parasympathetic and sympathetic, the treatment is cyproheptadine (World Q).

In neuroleptic malignant syndrome, it's a constant high BP, fever, flexion of extremities. I believe the treatment is dantrolene and it's MOA is to prevent the release of calcium from the sarcoplasmic reticulum (World Q), somebody can correct me if I am wrong.
 
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Can't remember the cyproheptadine, good to know. That is all correct with the dantrolene.


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