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[1] Dose escalation is discouraged if tolerance develops

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This cascade is mechanistically distinct from that of GHRH analogs, and is the molecular basis for its complementary contribution to growth hormone release

Tremor, Hyperreflexia, Myoclonus, Shivering LOOK In patients presenting in the context of an increased dose, overdose or suspected drug interaction involving any serotonergic agent, serotonin syndrome is likely if any of the following are found: Spontaneous clonus Tremor WITH hyperreflexia Ocular or inducible clonus AND agitation, sweating or hypertonia WITH fever Think of other differentials Other toxidromes: e.g