Spectrum of symptoms of serotonergic toxicity
| Severity | Neuromuscular excitation | Altered mental status | Autonomic dysfunction |
|---|---|---|---|
| Mild | Hyperreflexia Tremor Myoclonus | Anxiety Restlessness Insomnia | Diaphoresis Mydriasis Tachycardia |
| Moderate | Opsoclonus Spontaneous or inducible clonus | Agitation | Hypertension Hyperthermia (< 40°C, < 104°F) Hyperactive bowel sounds Diarrhea, nausea, vomiting |
| Severe | Rigidity Respiratory failure Tonic-clonic seizure | Coma Delirium Confusion | Severe hyperthermia (≥ 40°C, ≥ 104°F) Dynamic blood pressure |