Serotonin Syndrome Scale

Parameter

Finding

Points

agitation

none

0

slight and intermittent

1

moderate (unrest sitting)

2

severe and permanent; prolonged sitting is nearly impossible; patient always feels restless

3

disorders of orientation

none

0

mild

1

moderate

2

severe, or more than 1 quality significantly impaired

3

myoclonus

none

0

patient reports some short episodes

1

patient reports repeated episodes; isolated myocloni are visible

2

permanent, visible myocloni

3

hyperreflexia

none

0

hyperreflexia with normal reflexogenic zone

1

hyperreflexia with enlarged reflexogenic zone; exhaustible cloni

2

hyperreflexia with enlarged reflexogenic zone; non-exhaustible cloni

3

tremor

none

0

tremor with small amplitude; functioning is not impaired

1

tremor with a significant amplitude; functioning (holding a cup, writing, etc.) is moderately impaired

2

tremor with high amplitude; functioning severely impaired

3

dizziness (subjective feeling)

none

0

slight and intermittent feeling of dizziness

1

patient feels dizzy most of the time, but functioning (moving, standing) is not impaired

2

patient always feels dizzy; functioning is affected

3

hyperthermia

sublingual temperature < 37°C

0

sublingual temperature 37-37.9°C

1

sublingual temperature 38-38.9°C

2

sublingual temperature >= 39.0 37°C

3

sweating

none

0

subjective feeling of increased sweating

1

moist skin, some beads of perspiration can be seen

2

visible beads of perspiration with wet clothes or bedspread

3

diarrhea

none

0

feces with reduced consistency, but normal frequency

1

liquid feces and/or frequency 1-3 per day

2

liquid with frequency > 3 per day

3