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Profound hypothermia secondary to normal ziprasidone use.
Gregory M Gibbons1, David A Wein, Richard Paula
1Department of Emergency Medicine, University of South Florida, Tampa, FL 33606, USA. gmgibbons@gmail.com
The American Journal of Emergency Medicine
|July 9, 2008
Summary
Atypical antipsychotic medications, like ziprasidone, can cause severe hypothermia. This drug-induced hypothermia may result from the medication
Area of Science:
- Emergency Medicine
- Clinical Pharmacology
- Toxicology
Background:
- Clinically significant hypothermia is a common emergency medicine presentation.
- Typical causes include environmental exposure, infection, and endocrinopathies.
- Drug-induced hypothermia is a less common but critical differential diagnosis.
Observation:
- A 69-year-old male patient presented with severe hypothermia (oral temperature 85°F / 29.4°C).
- The patient was receiving ziprasidone 80 mg twice daily, an atypical antipsychotic.
- No other common causes of hypothermia were immediately apparent.
Findings:
- Atypical antipsychotics, including ziprasidone, are implicated in drug-induced hypothermia.
- The mechanism may involve antagonism of dopamine and serotonin receptors (5-HT2), disrupting thermoregulation.
- Alpha-1 receptor antagonism leading to vasodilation and heat loss is another proposed mechanism.
Implications:
- Healthcare providers should consider atypical antipsychotic medications as a potential cause of hypothermia.
- This case highlights the importance of a thorough medication history in evaluating hypothermia.
- Awareness of drug-induced hypothermia can lead to timely diagnosis and appropriate management.
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