Both serotonin syndrome (SS) and neuroleptic malignant syndrome (NMS) are associated with exposure to, respectively, to pro-serotonergic (e.g. selective serotonin reuptake inhibitor, serotonin norepinephrine reuptake inhibitors and tricyclic antidepressants) and antipsychotic drugs. They often present with key clinical features including mental status changes, autonomic instability, hyperthermia, and rigidity. However, each represents a different and potentially life-threatening syndrome with varying pathophysiology, distinct symptoms, and important treatment differences. As such, quick and accurate diagnosis of signs and symptoms in mild cases is critical to prevent progression to more severe cases. With this in mind, this chapter will review the clinical features, epidemiology, pathophysiology, and treatment options for serotonin syndrome and neuroleptic malignant syndrome.
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