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NMS vs Serotonin Syndrome
NMS is a diagnosis of exclusion. Ruling out other conditions such as drug withdrawal, agitated delirium, environment heatstroke and infection is necessary.
Serotonin syndrome must be ruled out, and usually presents as an agitated delirium with confusion, restlessness, myoclonus and tachycardia.
Severe progressive cases of serotonin syndrome can appear identical to NMS and may respond to dantrolene. This extreme form is usually seen with MAOI’s.