Hyperthermia chlorpromazine

Serotonin syndrome SSRIs, second generation antidepressants, MAOIs, linezolid, tramadol, meperidine, fentanyl, ondansetron, sumatriptan, MDMA, LSD, St. John s wort, ginseng Hypertension, hyperreflexia, tremor, clonus, hyperthermia, hyperactive bowel sounds, diarrhea, mydriasis, agitation, coma onset within hours Sedation (benzodiazepines), paralysis, intubation and ventilation consider 5-HT2 block with cyproheptadine or chlorpromazine... 

Intoxication with MAO inhibitors is unusual. Agitation, delirium, and neuromuscular excitability are followed by obtunded consciousness, seizures, shock, and hyperthermia. Supportive treatment is usually all that is required, though sedative phenothiazines with adrenoceptor-blocking action, such as chlorpromazine, may be useful. 

Rare, familial hyperthermia (41 °C) associated with inhalation anaesthetics, muscle relaxants, tricyclic antidepressants, phenothiazine neuroleptics (particularly chlorpromazine) monoamine oxidase inhibitors and haloperidol. 

Hyperthermia and labile blood pressure occurred in a patient taking chlorpromazine, phenelzine, and clomipramine (56). 

Overdose is common amongst users (up to 22% of heavy users report losing consciousness). The desired euphoria and excitement turns to acute fear, with psychotic symptoms, convulsions, hypertension, haemorrhagic storke, tachycardia, arrhythmias, hyperthermia coronary vasospasm (sufficient to present as the acute coronary syndrome with chest pain and myocardial infarction) may occur, and acute left ventricular dysfunction. Treatment is chosen according to the clinical picture (and the known mode of action), from amongst, e.g. haloperidol (rather than chlorpromazine) for mental disturbance diazepam for convulsions a vasodilator, e.g. a calcium channel blocker, for hypertension glyceryl trinitrate for myocardial ischaemia (but not a p-... 

Acute poisoning is manifested by excitement and peripheral sympathomimetic effects convulsiorrs may occur also, in acute or chronic overuse, a state resembling hyperactive paranoid schizophrenia with hallucinations develops. Hyperthermia occurs with cardiac arrhythmias, vascular collapse and death. Treatment is chlorpromazine with added antihypertensive, e.g. labetalol, if necessary these provide sedation and a- and P-adrenoceptor blockade (not a P-blocker alone), rendering unnecessary the enhancement of elimination by urinary acidification. 

Gastric lavage and activated charcoal are considered to be effective decontamination measures, whereas ipecac-induced emesis should be avoided after massive ingestion, because of the risk of seizures. Aggressive use of benzodiazepine is a reasonable first choice to treat associated involuntary movements, tremor, hyperactivity, and agitation. Chlorpromazine or haloperidol can also be used, especially for serious, life-threatening symptoms, including hypertensive crises and severe hyperthermia, and labetalol or sodium nitroprusside are reasonable choices for rapid stabilization of blood pressure. 

Neuroleptic malignant syndrome is characterised by hyperthermia, severe muscle rigidity, autonomic dysfunction and altered mental state. A study of 24 patients who had received a variety of antipsychotics (chlorpromazine, zotepine, paliperidone, bromperidol, supliride, risperidone, thioridazine, olanzapine, fluphenazine, haloperidol, levoproma-zine) demonstrated a temporal relationship of muscle rigidity and elevated creatine kinase to fever [46 ]. 

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