It tells you about the potential risk of serotonin syndrome. If you take these medicines, be sure to read the warning on the packaging. Common triptans include sumatriptan (Imitrex), zolmitriptan (Zomig), frovatriptan (Frova), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), and eletriptan (Relpax). Serotonin/norepinephrine reuptake inhibitors (SSNRIs) include duloxetine (Cymbalta) and venlafaxine (Effexor). For example, you can develop serotonin syndrome if you take migraine medicines called triptans together with antidepressants called selective serotonin reuptake inhibitors (SSRIs), and selective serotonin/norepinephrine reuptake inhibitors (SSNRIs).Ĭommon selective serotonin reuptake inhibitors (SSRIs) include citalopram (Celexa), sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), and escitalopram (Lexapro). Certain illegal drugs and dietary supplements also are associated with serotonin syndrome. Serotonin syndrome can occur when you increase the dose of such a drug or add a new drug to your regimen. The medicines cause too much serotonin to be released or to remain in the brain area. Serotonin syndrome most often occurs when two medicines that affect the body’s level of serotonin are taken together at the same time. Serotonin syndrome is a potentially life threatening condition due to excessive serotonin in your body 3). Neuroleptic malignant syndrome vs Serotonin syndrome If neuroleptic malignant syndrome is due to the rapid withdrawal of dopaminergic medication, rapid re-institution of the medication may improve symptoms. The empiric medications most frequently used for refractory neuroleptic malignant syndrome include bromocriptine mesylate, a dopamine agonist, and dantrolene sodium, a muscle relaxant. Treatment involves immediately discontinuing the offending neuroleptic or antipsychotic drug, aggressive supportive care to manage and prevent complications, and pharmacologic therapy in severe cases. While uncommon, neuroleptic malignant syndrome remains an important part of the differential diagnosis of fever and mental status changes because it requires early diagnosis and treatment to prevent significant mortality and death. If the waiting period is more than two weeks, the percentage of patients experiencing a relapse drops to about 30 2). If the waiting period is two weeks or less, about 63% will have a recurrence. The risk of recurrence is closely related to the time elapsed between the end of the original episode of neuroleptic malignant syndrome and the beginning of renewed administration of an antipsychotic drug. Recurrence of an attack of neuroleptic malignant syndrome is not uncommon. Neuroleptic malignant syndrome can also occur in people taking anti-Parkinsonism drugs known as dopaminergics if those drugs are discontinued abruptly. In most cases, neuroleptic malignant syndrome develops within the first 2 weeks of treatment with the drug however, neuroleptic malignant syndrome may develop any time during the therapy period. Neuroleptic malignant syndrome (NMS) symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic instability. Neuroleptic malignant syndrome has been associated with virtually every neuroleptic agent but is more commonly reported with the typical antipsychotics like haloperidol and fluphenazine. Neuroleptic malignant syndrome (NMS) is a life-threatening, neurological disorder most often caused by an adverse reaction associated with the use of dopamine-receptor antagonist medications or with rapid withdrawal of dopaminergic medications 1). Neuroleptic malignant syndrome prognosis.Neuroleptic malignant syndrome treatment.Neuroleptic malignant syndrome diagnosis.Neuroleptic malignant syndrome symptoms.Signs and symptoms of neuroleptic malignant syndrome.Neuroleptic malignant syndrome pathophysiology.Medications associated with neuroleptic malignant syndrome.Neuroleptic malignant syndrome vs Serotonin syndrome.