Serotonin syndrome: A frequently missed diagnosis? Let the neurologist beware

Gretchen L. Birbeck, Peter W. Kaplan

Research output: Contribution to journalReview articlepeer-review


BACKGROUND - Serotonin syndrome (SS) results from drug-induced hyperserotonergic states. Although clinically SS appears similar to neuroleptic malignant syndrome (NMS), in SS there is a history of exposure to serotonergic agents. Unfortunately, treatments for NMS and SS are different, and misdiagnosis may result in recurrent disease or inappropriate, possibly harmful, therapies. Despite an increasing incidence, SS has received little attention in the neurology literature. REVIEW SUMMARY - To review the history, diagnosis, mechanism, and treatment of SS, we completed a MEDLINE search to identify possible SS cases previously diagnosed as other entities to illustrate the need for more clinical awareness of SS. Our MEDLINE search revealed 17 cases between 1987-1991 of possible or probable SS diagnosed as other entities. CONCLUSIONS - Many of these patients in whom the diagnosis of SS was not considered were on serotonergic agents for neurologic disease. SS was not mentioned as a potential cause in any of the cases. The nature of SS symptoms will bring patients to the attention of a neurologist. Given the multitude of serotonergic agents now in use, there is need for heightened awareness of SS among neurologists.

Original languageEnglish (US)
Pages (from-to)279-285
Number of pages7
Issue number5
StatePublished - Sep 1999


  • Neuroleptic malignant syndrome
  • Serotonin specific reuptake inhibitor
  • Serotonin syndrome

ASJC Scopus subject areas

  • Clinical Neurology


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