I’ve seen Serotonin Syndrome. Yeah it can be sneaky. Sometimes just stiffness. Delirium should be pretty obvious. One of the reasons we fear dealing with alcoholics, drug users and psych patients in the ER. They are all ticking time bombs and you can never let your guard down.
I understand about the abusers. Hospital had her full records even from onset of quad. What I think they've finally figured out also is persons with neurological damage are more prone to the adverse reaction for some reason.
I can't take AD'S and I have damage also involving sensory processing. The darn protocols they tried about sent me over the edge. The one thing that helped doctors are scared of which is Xanax. Everyday user since 1993. .5mg 4 x day :>} sometimes 3. If I'm out and it hits one goes under my tongue ASAP. If I'm home I just pick up an acoustic guitar.
I have Atypical General Anxiety Disorder sensory triggered that causes severe Myoclonic seizures in my upper torso from certain auditory and optical stimulation. My sensory uptake definitely doesn't need any more darn inhibiting LOL.
My wife is a 29 year Xanax user. Five doctors decided a valve in her heart would try to close when she was stressed simulating a heart attack but not one. Enzymes were always negative and she could pass drug induced treadmill. Thankfully she was on it also when the Serotonin Syndrome hit. It may have well saved her life.
We both know the Xanax risk, dangers, etc but neither have developed a tolerance to where it won't work. A lot of the real issues stem from improper initial dosages as to how much how often. I was started out 2mg twice a day. For about 14 hours a day it worked the rest of the time? Spasms. One doctor after I fired a few shrinks read my history involving Inner Ear issues and said no more AD's just Xanax and he cut the daily total dose in half but made it consistent by spreading it out.
First bad AD experience was Dysreflexia from blocked bladder. I realized from my experiences caring for my wife what was happening. Med was Paxil. I had a Foley two weeks. LOL.