What Does the First Week Mean in Reports of Antipsychotic-Associated Hypothermia?
A medication change can be important when reconstructing an episode of low body temperature. A 2017 systematic review of antipsychotic-associated hypothermia identified a temporal pattern in published case reports, together with substantial limits on what that pattern could establish.
Which cases produced the timing pattern?
The authors assembled 57 patient descriptions and excluded hypothermia occurring with toxic antipsychotic plasma levels. In 33 cases, hypothermia followed initiation of an antipsychotic or a dose increase. Of those 33, nine occurred within two days and fourteen occurred between two and seven days. Three lacked a reported interval.
Thus, the early timing pattern concerned the subgroup with a recent treatment change. Twenty cases occurred without a reported medication change, and four had an unknown change history.
What else appeared in the records?
Additional predisposing factors were described in 50 of the 57 cases. These included advanced age, benzodiazepine use, hypothyroidism, and exposure to cold. The review’s causality assessment was, on average, consistent with a possible adverse drug reaction.
Published reports provide a selected set of events. The review lacked the number of exposed patients for each medication, preventing calculation of incidence or reliable ranking of drugs by relative risk.
What records help an attorney evaluate the timeline?
A case-specific review can assemble medication administration records, recent dose changes, temperature measurements, environmental history, and concurrent illnesses or sedatives. The review supports investigating that combination of circumstances.
The reported timing can help identify questions for an expert. Whether a medication caused a particular episode, and whether the care met an applicable professional standard, require assessment of the individual record.
Source
Read the scientific paper in full. DOI 10.3389/fpsyt.2017.00165.
