Neuroleptic-induced hypothermia associated with amelioration of psychosis in schizophrenia

Lower Corneal Temperature in Neuroleptic-Treated vs. Drug-Free Schizophrenia Patients

“…thermoregulatory effectors, or indirectly by reducing the levels of endogenous cytokines such as IL-1ß, IL-6 and TNF-· [1,2,[16][17][18][19]. Hence, our finding may substantiate previous reports implying lower baseline core temperature in APD-treated vs. drug-free schizophrenia patients [3,8,19,20]. Both subgroups of neuroleptic-treated patients (with and without concomitant anticholinergic drugs) exhibited comparable corneal temperatures.…”

“…However, other anecdotal data also support our notion that schizophrenia patients' mental status, including 'core' psychotic symptoms (e.g. delusions, and hallucinations), might correlate with the patients' core temperature, and that the antipsychotic effect of neuroleptic drugs may be associated with a parallel decrease in core temperature [3].…”

“…Even so, accumulating data suggest that APDs may display lower baseline core body temperature via a direct effect on central thermoregulatory effectors (i.e., mainly hypothalamus) and/or indirectly by decreasing levels of endogenous pyrogenic cytokines such as interleukin (IL)-1, tumor necrosis factor (TNF)-· and IL-6 [1,2]. It was even anecdotally proposed that the therapeutic effect of APDs might correlate with a decrease in core body temperature of schizophrenia patients [3].…”

Hypothermie unter Olanzapin

“…Seit der Markteinführung von Olanzapin in den USA wurden 5 Fälle von Hypothermie nach Olanzapin-Einnahme (neben unseren 3 obig zitierten Kasuistiken) publiziert (Pubmed-Suche in PubMed nach "olanzapine AND hypothermia", 31.12.2010; [2,12,14,17,30] Clozapin, das im klinischen Wirk-und Nebenwirkungsspektrum Olanzapin äh-nelt, wird bezüglich seines Hypothermierisikos kontrovers diskutiert: Einerseits wurde an 8 chronisch-schizophrenen Patienten unter Clozapin verglichen mit Haloperidol eine deutlichere Erniedrigung der Körpertemperatur berichtet [16]. Andererseits wird bei antipsychotikaassoziierter Hypothermie zum Einsatz von Aripiprazol, Clozapin und Ziprasidon geraten, da diese Substanzen eine relativ geringe D2-und 5-HT2-Bindung aufweisen und eine hohe D2-und 5-HT2-Bindung mit einer erhöhten Inzidenz für antipsychotikaassoziierte Hypothermien zu korrelieren scheint [23].…”

Clozapine and olanzapine, but not haloperidol, reverse cold-induced and lipopolysaccharide-induced cutaneous vasoconstriction

“…Clozapine and olanzapine, atypical antipsychotic agents, reduce body temperature in humans and experimental animals, but there is no consensus concerning mechanisms underlying this effect (Heh et al 1988;Nash et al 1988;Menon et al 1990;Salmi et al 1994;Millan et al 1995;Salmi and Ahlenius 1996;Goudie et al 1999;Oerther and Ahlenius 2000). This may be at least partially because body temperature is a complex variable, encompassing processes affecting heat production and heat exchange with the external environment.…”