What does the “H” in SHIVERS of Serotonin Syndrome stand for?

In the context of Serotonin Syndrome, the acronym SHIVERS is used to help remember the key clinical features of this potentially life-threatening condition. The "H" specifically stands for hyperreflexia, which is an exaggerated response of the reflexes due to increased serotonergic activity in the central nervous system. This symptom is a critical indicator of the syndrome, as it reflects the heightened neuromuscular excitability associated with excessive serotonin levels.

Hyperreflexia can often be observed during physical examination, where a clinician might test reflexes and note an abnormal increase in their intensity or duration. Understanding this symptom is crucial for diagnosis and management of Serotonin Syndrome, alongside other symptoms represented in the SHIVERS acronym, such as shivering, hypertonia, increased vital signs, encephalopathy, and restlessness. Recognizing hyperreflexia and the other features allows healthcare providers to identify and promptly intervene in cases of Serotonin Syndrome, mitigating its complications.