TY - JOUR AU - Monti, Manuel AU - Mommi, Valeria AU - Forte, Maria Beatrice AU - Paciullo, Francesco AU - Francavilla, Francesca AU - Borgognoni, Francesco PY - 2018/02/19 Y2 - 2024/03/28 TI - Olanzapine-associated hypothermia: a case report of a rare event JF - Italian Journal of Medicine JA - Ital J Med VL - 12 IS - 1 SE - Case Reports DO - 10.4081/itjm.2018.937 UR - https://www.italjmed.org/ijm/article/view/itjm.2018.937 SP - 67-69 AB - Hypothermia, a potentially fatal condition, is defined as a drop of the body temperature below 35°C. The most common cause of severe hypothermia is the environmental exposure to low-temperatures. Other causes include septicemia, diabetic ketoacidosis, trauma, acute spinal cord injury, prolonged cardiac arrest and hypothyroidism. The hypothermia is an infrequent, but previously documented, adverse effect of antipsychotic medications. A 83-year-old Italian woman was transported to the Emergency Room with a reduced level of consciousness, Glasgow coma scale 7. She was bradycardic (heart rate 42 bpm), 80/150 mmHg blood pressure and respiratory rate 26/min. Her physical examination was significant for an anal temperature of 31°C. Blood exam and chest X-ray were unremarkable. In her clinical history, she was suffering from generalized anxiety disorder for the last 2 years and was prescribed olanzapine 7.5 mg daily. In recent days, the patient experienced a cognitive impairment with heat intolerance and had been reduced the dose of olanzapine 5 mg daily. On the basis of the clinical findings, the patient's body temperature and blood exam, the diagnosis of olanzapine-associated hypothermia was made. The patient was gradually rewarmed with blankets and warm saline infusion and the olanzapine therapy was discontinued. She gradually regained consciousness after 18 h and, after 1 day, the patient's body temperature increased up to 37.8°C with an improvement of the neurological conditions. We reported about the case of a patient treated with stable doses of olanzapine for a long period of time that developed hypothermia, a potentially fatal complication. This case shows that it is important to consider every change in the patient behavior, <em>e.g</em>., the poor resistance to heat present in our patient, that should exhibit warning sign of hypothermia. ER -