Guanabenz induced hypothermia in a poisoned elderly female

Guanabenz (Wytensin Wyeth-Ayerst Laboratories, Philadelphia, PA) is a centrally acting alpha 2 adrenergic agonist. Guanabenz shares structural and pharmacologic properties with the more commonly known sympatholytic agent clonidine. Little is known about guanabenz in overdose. Eleven cases of guanabenz poisoning have been reported in the literature and to the manufacturer to date and followed a clinical course comparable to clonidine poisoning. We report this case of guanabenz poisoning in an elderly woman who sustained protracted hypothermia following overdose. Hypothermia has been commonly associated with clonidine toxicity but has not been previously reported with guanabenz. Postulated mechanisms of clonidine induced hypothermia are discussed.