Are Neuroleptic Malignant Syndrome and Serotonin Syndrome the Same Syndrome?

Perspectives in Psychiatric Care

Volumn 47, Issue 1, 2011, Pages 58-62

  Steele, Debbie ^a   Keltner, Norman L ^b   McGuiness, Teena M ^a  

^a CALIFORNIA STATE UNIVERSITY   (United States)

^b UNIVERSITY OF ALABAMA AT BIRMINGHAM   (United States)

Author keywords

Neuroleptic malignant syndrome; Serotonin syndrome

Indexed keywords

DIBENZOTHIAZEPINE DERIVATIVE; DRUG DERIVATIVE; HALOPERIDOL; MIANSERIN; MIRTAZAPINE; NEUROLEPTIC AGENT; QUETIAPINE; TRICYCLIC ANTIDEPRESSANT AGENT;

CASE REPORT; DRUG COMBINATION; FATALITY; FEMALE; HUMAN; MIDDLE AGED; NEUROLEPTIC MALIGNANT SYNDROME; NOTE; PATHOPHYSIOLOGY; RISK FACTOR; SEROTONIN SYNDROME;

ANTIDEPRESSIVE AGENTS, TRICYCLIC; ANTIPSYCHOTIC AGENTS; DIBENZOTHIAZEPINES; DRUG THERAPY, COMBINATION; FATAL OUTCOME; FEMALE; HALOPERIDOL; HUMANS; MIANSERIN; MIDDLE AGED; NEUROLEPTIC MALIGNANT SYNDROME; RISK FACTORS; SEROTONIN SYNDROME;

EID: 79951884409     PISSN: 00315990     EISSN: 17446163     Source Type: Journal    
DOI: 10.1111/j.1744-6163.2010.00292.x     Document Type: Note

References (25)

1. Agar, L. (2010). Recognizing neuroleptic malignant syndrome in the emergency department: A case study. Perspectives in Psychiatric Care, 46, 143-151. doi:10.1111/j.1744-6163.2010.00250.x
2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision).Washington, DC: American Psychiatric Association.
3. Bartlett, D., & Muller, A. (2006). Serotonin syndrome: A subtle toxicity. Journal of Emergency Medicine, 32, 277-279.
4. Bhanushali, M., & Tuite, P. (2004). The evaluation and management of patients with neuroleptic malignant syndrome. Neurologic Clinics of North America, 22, 389-411.
5. Boyer, E., & Shannon, M. (2005). The serotonin syndrome. New England Journal of Medicine, 352, 1112-1120.
6. Carbone, J. (2000). The neuroleptic malignant and serotonin syndromes. Psychiatric Emergencies, 18(2), 317-325.
7. Demirkiran, M., Jankovic, J., & Dean, J. (1986). Ecstasy intoxication: An overlap between serotonin syndrome and neuroleptic malignant syndrome. Clinical Neuropharmacology, 19, 157-164.
8. Dvir, Y., & Smallwood, P. (2008). Serotonin syndrome: A complex but easily avoidable condition. General Hospital Psychiatry, 30, 284-287. doi:10.1016/j.genhosppsych.2007.09.007
9. Fink, M. (1996). Toxic serotonin syndrome or neuroleptic malignant syndrome? Pharmacopsychiatry, 29, 159-161.
10. Gillman, P. K. (n.d.). Neuroleptic malignant syndrome and serotonin toxicity. Retrieved from
11. Gillman, P. K. (2006). A review of serotonin toxicity data: Implications for the mechanism of antidepressant drug action. Biological Psychiatry, 59, 1046-1051. doi:10.1016/j.biopsych.2005.11.016
12. Glennon, R. A. (1990). Serotonin receptors: Clinical implications. Neuroscience & Behavioral Reviews, 14, 35-47. doi:10.1016/S0149-7634(05)80158-7
13. Graudins, A., Stearman, A., & Chan, B. (1998). Treatment of the serotonin syndrome with cyproheptadine. Journal of Emergency Medicine, 16, 615-619. doi:10.1016/S0736-4679(98)00057-2
14. Kalueff, A. V., LaPorte, J. L., & Murphy, D. L. (2008). Perspectives on genetic animal models of serotonin toxicity. Neurochemistry International, 52, 649-658.
15. Keltner, N., & Folks, D. (2005). Psychotropic drugs (4th ed.). St. Louis, MO: Elsevier.
16. Kontaxakis, V. P., Havaki-kontaxaki, B. J., Christodoulou, N. G., Paplos, K. G., & Christodoulou, G. N. (2003). Olanzapine-associated neuroleptic malignant syndrome: Is there an overlap with the serotonin syndrome? Annals of General Hospital Psychiatry, 2, 10. doi:10.1186/1475-2832-2-10. Retrieved from
17. Lappa, A., Podesta, M., Capelli, O., Castagna, A., Di Placido, G., Alampi, D., & Semeraro, F. (2002). Successful treatment of a complicated case of neuroleptic malignant syndrome. Intensive Care Medicine, 28, 976-977. doi:10.1007/s00134-002-1241-6
18. Mazzola-Pomietto, P., Aulakh, C. S., Wozniak, K. M., Hill, J. L., & Murphy, D. L. (1995). Evidence that 1-(2, 5-dimethyoxy-4-iodophenyl)-2-aminopropane (DOI)-induced hyperthermia in rats is mediated by stimulation of 5-HT2A receptors. Psychopharmacology, 117, 193-199. doi:10.1007/BF02245187
19. Nisijima, K., Shioda, K., & Iwamura, T. (2007). Neuroleptic malignant syndrome and serotonin syndrome. In H. Sharma (Ed.), Neurobiology of Hyperthermia (pp. 81-104). Amsterdam: Elsevier.
20. 2A receptor antagonists completely prevent the development of hyperthermia in an animal model of the 5-HT syndrome. Brain Research, 890, 23-31.
21. Odagaki, Y. (2009). Atypical neuroleptic malignant syndrome or serotonin toxicity associated with atypical antipsychotics? Current Drug Safety, 4(1), 84-93.
22. Sachdev, P. S. (2005). A rating scale for neuroleptic malignant syndrome. Psychiatry Research, 135, 249-256. doi:10.1016/j.psychres.2005.05.003
23. Shioda, K., Nisijima, K., Yoshino, T., & Kato, S. (2004). Extracellular serotonin, dopamine and glutamate levels are elevated in the hypothalamus in a serotonin syndrome animal model induced by tranylcypromine and fluoxetine. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 28, 633-640.
24. Stahl, S. (2008). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (3rd ed.). New York: Cambridge University Press.
25. Strawn, J. R., Keck, P. E. Jr, & Caroff, S. N. (2007). Neuroleptic malignant syndrome. American Journal of Psychiatry, 164(6), 870-876. doi:10.1176/appi.ajp.164.6.870