Pearls & Pitfalls Among patients with hyperthermia, altered mental status, autonomic hyperactivity, and muscular rigidity factors that favor serotonin syndrome over neuroleptic malignant syndrome include use of serotonergic drugs, onset within 24 hours, and hyperreflexia Treatment of Serotonin Syndrome Supportive measures Sometimes cyproheptadine When serotonin syndrome is recognized and treated promptly, the prognosis is usually good (1).