Hypothermia following antipsychotic drug use

Marum, Rob J. van; Wegewijs, Michelle A.; Loonen, Anton J. M.; Beers, Erna

doi:10.1007/s00228-007-0294-4

Cited by 82 publications

(145 citation statements)

References 33 publications

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“…Moreover, the patient in this case report was diagnosed as having bipolar affective disorder as opposed to schizophrenia, which was the most common psychiatric disorder associated with previously reported hypothermia [van Marum et al 2007]. Finally the occurrence of this side effect in a patient living in a country with a warm climate also highlights the importance of this case as in comparison with previous reports [Kreuzer et al 2012;Schwaninger et al 1998].…”

Section: Discussionsupporting

confidence: 59%

De Novo delayed onset hypothermia secondary to therapeutic doses of risperidone in bipolar affective disorder

Perera¹,

Yogaratnam²

2013

Therapeutic Advances in Psychopharmacology

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Section: Discussionsupporting

confidence: 59%

De Novo delayed onset hypothermia secondary to therapeutic doses of risperidone in bipolar affective disorder

Perera¹,

Yogaratnam²

2013

Therapeutic Advances in Psychopharmacology

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“…While malignant hyperthermia is a well-known and potentially fatal adverse effect of antipsychotics, its opposite, hypothermia, is less wellrecognized. In 2007, van Marum [5], using the World Health Organization database, reviewed 480 cases of hypothermia associated with the use of antipsychotic medication. A large number of these, 44, were linked to olanzapine.…”

Section: Discussionmentioning

confidence: 99%

“…A large number of these, 44, were linked to olanzapine. Body temperature is downregulated by dopamine and upregulated by serotonin so that drugs potent at both these receptors (like olanzapine) are the ones most likely to cause hypothermia, especially, it has been reported, at drug initiation or whenever the dose is rapidly increased [5,6]. Hypothermia has been known to occur after even one dose of a new potentially offending drug when taken by a susceptible subject.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotics, Hypothermia, Undressing, and Death

Seeman¹

2017

Glob J Medical Clin Case Rep

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One of the lesser-known adverse effects of antipsychotic medication is hypothermia, a signifi cant and protracted plunge in body temperature. Known risk factors are older age and exposure to a newfor-the-person antipsychotic drug. Hypothermia impairs cognitive function, often resulting in a delirium that can paradoxically induce the prescription of escalating doses of the offending drug. As hypothermia increases, the subjective experience of the person may be one of overwhelming heat that can lead to the person shedding protective clothing, an action that can precipitate death. Case Report Antipsychotics Case ExampleA 62-year-old male patient had, for many years, been suffering from schizophrenia and had more recently Three days later, he was found frozen to death on the sidewalk outside his residence. He was completely naked; his clothes were stacked in a neat pile beside him. Although there was no suicide note, the coroner attributed the death to suicide. Given the patient's psychiatric history, the conclusion was that he had deliberately walked out into the cold and taken off his clothes in order to freeze himself to death. Suicide while in the nude is, apparently, a known entity [2], (though purposefully freezing oneself to death has never been reported in this context). The patient's extended family and long-term clinicians stated that there was no previous history of suicidal threats or gestures; nevertheless, the care providers who had looked after him during his recent hospital stay and thought of him as "attention-seeking" considered it possible that he had deliberately staged a melodramatic ending [3] to an otherwise uneventful life. DiscussionThe death of this patient occurred twenty years ago, but it has remained a puzzle. Having known the patient for many years, I cannot believe that he committed suicide. I have wondered whether he may have been a sleepwalker. Like hypothermia, sleepwalking is a rarely recognized side effect of antipsychotic medication [4]. The naked streaking in the hospital at night may have been a form of sleepwalking, which would account for his afterwards not understanding what he had done wrong. The fi nal walk out into the street and the shedding of clothes may have been the action of a sleepwalker.The other explanatory hypothesis is hypothermia, defi ned as body temperature falling below 35°C. While malignant hyperthermia is a well-known and potentially fatal adverse effect of antipsychotics, its opposite, hypothermia, is less wellrecognized. In 2007, van Marum [5], using the World Health Organization database, reviewed 480 cases of hypothermia associated with the use of antipsychotic medication. A large number of these, 44, were linked to olanzapine.

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“…Core temperature itself can increase by several degrees during fever , exertional/environmental hyperthermia (Leon and Helwig 2010), or as part of adverse drug reactions (Hopkins 2011). A decrease by several degrees may occur during accidental (Reed 1996) or therapeutic hypothermia (The Hypothermia after Cardiac Arrest Study Group 2002; Bernard et al 2002), sepsis (Clemmer et al 1992), trauma (Jurkovich et al 1987), or certain drug intoxications (van Marum et al 2007;Wilson and Waring 2007). Solid organs harvested for transplantation may be stored at more extreme hypothermia for prolonged periods prior to transplant.…”

Section: Introductionmentioning

confidence: 99%

Shifts in temperature within the physiologic range modify strand-specific expression of select human microRNAs

Potla

Singh

Atamas

et al. 2015

RNA

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Previous studies have revealed that clinically relevant changes in temperature modify clinically relevant gene expression profiles through transcriptional regulation. Temperature dependence of post-transcriptional regulation, specifically, through expression of miRNAs has been less studied. We comprehensively analyzed the effect of 24 h exposure to 32°C or 39.5°C on miRNA expression profile in primary cultured human small airway epithelial cells (hSAECs) and its impact on expression of a targeted protein, protein kinase C α (PKCα). Using microarray, and solution hybridization-based nCounter assays, with confirmation by quantitative RT-PCR, we found significant temperature-dependent changes in expression level of only five mature human miRNAs, representing only 1% of detected miRNAs. Four of these five miRNAs are the less abundant passenger (star) strands. They exhibited a similar pattern of increased expression at 32°C and reduced expression at 39.5°C relative to 37°C. As PKCα mRNA has multiple potential binding sites for three of these miRNAs, we analyzed PKCα protein expression in HEK 293T cells and hSAECs. PKCα protein levels were lowest at 32°C and highest at 39.5°C and specific miRNA inhibitors reduced these effects. Finally, we analyzed cell-cycle progression in hSAECs and found 32°C cells exhibited the greatest G1 to S transition, a process known to be inhibited by PKCα, and the effect was mitigated by specific miRNA inhibitors. These results demonstrate that exposure to clinically relevant hypothermia or hyperthermia modifies expression of a narrow subset of miRNAs and impacts expression of at least one signaling protein involved in multiple important cellular processes.

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Hypothermia following antipsychotic drug use

Cited by 82 publications

References 33 publications

De Novo delayed onset hypothermia secondary to therapeutic doses of risperidone in bipolar affective disorder

De Novo delayed onset hypothermia secondary to therapeutic doses of risperidone in bipolar affective disorder

Antipsychotics, Hypothermia, Undressing, and Death

Shifts in temperature within the physiologic range modify strand-specific expression of select human microRNAs

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