Step I Serotonin vs NMS

[tideleonheart]

How do you tell the difference between a Neuroleptic Malignant syndrome and a Serotonin syndrome without a specific history of certain drug use.

For example, a clinical scenario of a patient and the question asks what drug the patient is most likely on.

The only thing I'm seeing really is possibly seizures for serotonin syndrome?

 

[Inuranic]

According to UWorld, you see rigidity in NMS but not SS (I think...). However, in FA they both have rigidity, but NMS has myoglobinuria where SS does not (again, I think...).

Feel free to check me on that.

 

[doc29]

How do you tell the difference between a Neuroleptic Malignant syndrome and a Serotonin syndrome without a specific history of certain drug use.

For example, a clinical scenario of a patient and the question asks what drug the patient is most likely on.

The only thing I'm seeing really is possibly seizures for serotonin syndrome?

NMS- Fever,Encephalopathy,Vital unstable,Elevated enzyme,Rigidity of muscles.(according to FA)
Serotonin syndrome- Confusion,headache, shivering, diarrhea,hyperthermia, sweating, seizures...(UW has a question about serotonin syndrome)

 

[Ookluh]

Did a question on NMS earlier.. at the end it mentions that NMS has muscle rigidity, whereas Serotonin Syndrome has myoclonus.

 

[IMGUSMLEStep1]

I've noticed that flushing is usually mentioned for Serotonin syndrome but not NMS.

 

[Vikingwizardguy]

who cares. Treat em both with dantrolene and fluids, then get the Rx history later.

 

[username456789]

who cares.

The dweebs who write the test.

 

[norealname]

Serotonin Syndrome: restlessness, insomnia, nausea, diarrhea, delirium, compulsive water drinking

Neuroleptic Malignant Syndrome: fever, fluctuating vitals (e.g. blood pressure), muscular rigidity

 

[aashkab]

i just look for diarrhea, seizures, flushing to make it serotonin. but good thread because i was kind of confused as well.

 

[aashkab]

another question also in the same line, why are there different symptoms for "carcinoid tumors" than serotonin syndrome? is it becuase SSRI works at CNS more so or something?

you still have the flushing, diarrhea, etc but no seizures i think with the carcinoid. you also get the right sided valve lesion.

just wanted to throw this into the mix to see yall's perspective, for a while i just kind of assumed it was all wordplay but now i'm realizing they are different