Hypothermia occurs when the core body temperature falls below 95 degrees F (35 degrees C). Several conditions which can occur in the psychiatric population increase the risk of hypothermia: nocturnal enuresis, seizure disorder, debilitating physical illness, and mental retardation. The risk of hypothermia is further increased by the use of several classes of medications used to treat psychiatric disorders: antipsychotics, beta-adrenergic antagonists, benzodiazepines, and other sedatives. Air-conditioning is also identified as a risk factor for hypothermia. Hypothermia is posited as a possible link between antipsychotic medication and sudden unexplained death. Suggestions for further investigation are made, and clinical recommendations are offered to reduce the risk of hypothermia in the psychiatric patient population.

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Conventional wisdom regarding management of opioid dependence in pregnancy calls for methadone maintenance in nearly all cases. The scientific literature and historical background upon which this recommendation is based, newer evidence indicating the safety of methadone discontinuation during pregnancy and recent studies raising concerns about the effects of methadone on the fetus and neonate are reviewed. More flexibility in the management of opioid dependence during pregnancy is recommended.