Serotonin syndrome and neuroleptic malignant syndrome (NMS) are two life-threatening toxicologic emergencies that every emergency medicine physician, intensivist, hospitalist, nurse, pharmacist, and trainee should recognize early. In this toxicology deep dive, we review: • Neuroleptic malignant syndrome (NMS) • Serotonin syndrome • Key clinical differences • Pathophysiology • Causative medications • Hyperthermia • Clonus vs rigidity • Hyperreflexia • Autonomic instability • Elevated CK and rhabdomyolysis • Differential diagnosis • ICU and emergency department management • Supportive care strategies • Cyproheptadine, bromocriptine, and dantrolene This episode also includes a focused comparison section on how to rapidly differentiate serotonin syndrome from neuroleptic malignant syndrome at the bedside. This episode is designed for physicians, nurses, pharmacists, trainees, respiratory therapists, and anyone interested in emergency critical care medicine and toxicology. 🎥 YouTube video: https://www.youtube.com/watch?v=qdWPkutb9oE 📚 Download the study guide + access our complete emergency critical care curriculum: https://www.patreon.com/c/WhiteBoardMedicine Our Patreon includes: • PDF study guides for every episode • Emergency critical care mini-courses • Practice questions • Ad-free content • A structured ICU curriculum 🎧 WhiteBoard Medicine Podcast: https://podcasts.apple.com/us/podcast/whiteboard-medicine-emergency-and-critical-care/id1808306430 DISCLAIMER: This content is intended for educational purposes only and should not be considered medical advice. Clinical decisions should always be made using independent medical judgment, current guidelines, institutional protocols, and consultation with appropriate specialists. This content does not establish a physician-patient relationship and may not reflect the views of any affiliated institutions or employers.

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