Heatstroke in psychiatric patients: two cases and a review

Two fatal cases of heatstroke in psychiatric patients are described. A literature search revealed published reports of heatstroke involving 51 psychiatric patients, 22 of whom died. The mean age of these patients was 44 years; the majority has schizophrenia. Almost all were male and were taking antipsychotic or other drugs with anticholinergic effects. The implications for prevention, recognition, and treatment are discussed.