PT  - JOURNAL ARTICLE
AU  - Rupal Dosi
AU  - Annirudh Ambaliya
AU  - Harshal Joshi
AU  - Rushad Patell
TI  - Serotonin syndrome versus neuroleptic malignant syndrome: a challenging clinical quandary
AID  - 10.1136/bcr-2014-204154
DP  - 2014 Jun 23
TA  - BMJ Case Reports
PG  - bcr2014204154
VI  - 2014
4099  - http://casereports.bmj.com/content/2014/bcr-2014-204154.short
4100  - http://casereports.bmj.com/content/2014/bcr-2014-204154.full
AB  - Serotonin syndrome and neuroleptic malignant syndrome are two drug toxidromes that have often overlapping and confusing clinical pictures. We report a case of a young man who presented with alteration of mental status, autonomic instability and neuromuscular hyperexcitability following ingestion of multiple psychiatric and antiepileptic medications. The patient satisfied criteria for serotonin syndrome and neuroleptic malignant syndrome, and based on the characteristic clinical features, laboratory findings and clinical course it was concluded that the patient had both toxidromes. The patient was managed with cyproheptadine and supportive measures, and recovered over the course of 3 weeks. A brief review of literature highlighting the diagnostic clues as well as the importance of recognising and distinguishing the often missed and confounding diagnoses follows.