Great Discussion!
| NMS | Serotonin Syndrome | |
| Etiology | Too Little Dopamine | Too much serotonin |
| Onset | Days to Weeks | Usually < 24 hours (more acute than NMS) |
| Neuromuscular Findings | Bradyreflexia, severe muscular rigidity | Hyperreactivity (tremor, myoclonus, reflexes, ocular clonus) |
| Pupils | Normal | Dilated |
| Treatment | Supportive care, consider bromocriptine | Benzodiazepines, cyproheptadine in certain cases |
| Resolution | Days to weeks | < 24 hours |
SCVMC IM Chief Resident Blog 