Table 2

Parkinsonism-hyperpyrexia and serotonin syndromes

Parkinsonism-hyperpyrexia syndromeSerotonin syndrome
Muscle rigidity, prominent akinesiaTremor, myoclonus, akathisia, hypertonicity
Altered mental status
Hyperthermia
Rhabdomyolysis
Trigger factors
Infection, trauma, medication changesDrug combinations: MAO inhibitor, SSRI, tricyclic antidepressant, opioids
Treatment
Escalating dopaminergic treatmentStopping the causative drug
Supportive intensive care management
  • MAO, monoamine oxidase B; SSRI, selective-serotonin reuptake inhibitor.