Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0066
Trends in Psychiatry and Psychotherapy
Case Report

Heat stroke during long-term clozapine treatment: should we be concerned about hot weather?

Heat stroke durante tratamento de longo prazo com clozapina: devemos nos preocupar com o tempo quente?

Maurício Scopel Hoffmann; Lucas Mendes Oliveira; Maria Inês Rodrigues Lobato; Paulo Belmonte-de-Abreu

Downloads: 0
Views: 379

Abstract

Objective To describe the case of a patient with schizophrenia on clozapine treatment who had an episode of heat stroke. Case description During a heat wave in January and February 2014, a patient with schizophrenia who was on treatment with clozapine was initially referred for differential diagnose between systemic infection and neuroleptic malignant syndrome, but was finally diagnosed with heat stroke and treated with control of body temperature and hydration. Comments This report aims to alert clinicians take this condition into consideration among other differential diagnoses, especially nowadays with the rise in global temperatures, and to highlight the need for accurate diagnosis of clinical events during pharmacological intervention, in order to improve treatment decisions and outcomes.

Keywords

Antipsychotic, heat wave, neuroleptic malignant syndrome, thermoregulation

Resumo

Objetivo Descrever o caso de um paciente com esquizofrenia em tratamento com clozapina acometido por um episódio de heat stroke. Descrição do caso Durante uma onda de calor em janeiro e fevereiro de 2014, um paciente com esquizofrenia em tratamento com clozapina foi inicialmente encaminhado para diagnóstico diferencial de infecção sistêmica e síndrome neuroléptica maligna, tendo obtido o diagnóstico final de heat stroke, tratado com controle de temperatura corporal e hidratação. Comentários Este relato de caso tem como objetivo alertar os clínicos para este diagnóstico diferencial, que pode surgir com mais frequência à medida que as temperaturas globais continuarem a aumentar, e também destacar a importância da realização de um diagnóstico mais acurado, que possa melhorar as decisões de tratamento e os desfechos clínicos para os pacientes.

Palavras-chave

Antipsicóticos, onda de calor, síndrome neuroléptica maligna, termorregulação

References

Kudoh A, Takase H, Takazawa T. Chronic treatment with antipsychotics enhances intraoperative core hypothermia. Anesth Analg. 2004;98:111.

Bouchama A, Dehbi M, Mohamed G, Matthies F, Shoukri M, Menne B. Prognostic factors in heat wave related deaths: a meta-analysis. Arch Intern Med. 2007;167:2170-6.

Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002;346:1978-88.

Kerwin RW, Osborne S, Sainz-Fuertes R. Heat stroke in schizophrenia during clozapine treatment: rapid recognition and management. J Psychopharmacol. 2004;18:121-3.

Clark WG. Changes in body temperature after administration of amino acids, peptides, dopamine, neuroleptics and related agents. Neurosci Biobehav Rev. 1979;3:179-231.

Benarroch EE. Thermoregulation: recent concepts and remaining questions. Neurology. 2007;69:1293-7.

Climate Change 2014: Impacts, adaptation, and vulnerability. Part A: global and sectoral aspects. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Interntet]. 2014.

Argaud L, Ferry T, Le QH, Marfisi A, Ciorba D, Achache P. Short- and long-term outcomes of heatstroke following the 2003 heat wave in Lyon, France. Arch Intern Med. 2007;167:2177-83.

Luber G, McGeehin M. Climate change and extreme heat events. Am J Prev Med. 2008;35:429-35.

Trollor JN, Chen X, Sachdev PS. Neuroleptic malignant syndrome associated with atypical antipsychotic drugs. CNS Drugs. 2009;23:477-92.

6169e1b3a953955c131c30a3 trends Articles
Links & Downloads

Trends Psychiatry Psychother

Share this page
Page Sections