Special Syndromes: Serotonin Syndrome, Neuroleptic Malignant Syndrome, and Catatonia

  • Julia Kulikowski
  • Usha Parthasarathi


Serotonin syndrome (SS), neuroleptic malignant syndrome (NMS), and catatonia are neuropsychiatric conditions associated with motor and behavioral manifestations. These three conditions share some pathophysiology, may present with similar clinical signs, and, therefore, may be unrecognized or misdiagnosed. Catatonia and NMS can be mistaken for each other; SS in the more severe cases is accompanied by motor dysfunction. Despite some overlap in phenomenology, each of these conditions has a unique etiology and requires a different management approach, which makes their differentiation important. Severe and/or unmitigated cases of each condition can progress to become fatal. Early identification, diagnosis, and appropriate management is critical, especially in geriatric patients. The inpatient psychiatry unit is an optimal setting in which these syndromes can be recognized and treated, primarily by ruling out other conditions with accessible and rapid laboratory studies, while monitoring/adjusting medications.


NMS Neuroleptic malignant syndrome Catatonia Serotonin syndrome 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Julia Kulikowski
    • 1
  • Usha Parthasarathi
    • 2
  1. 1.McMaster UniversityHamiltonCanada
  2. 2.McMaster University, St. Joseph’s HealthcareHamiltonCanada

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