Medication and pharmacological aspects: effects of high temperatures

At risk groups

Psychiatric patients: Most psychotropic drugs have a substantial impact on body temperature regulation as a result of its numerous effects on the hypothalamus.

Psychiatric patients are at great risk (three to four times higher incidence of heat-related deaths) of developing a heat-related illness such as heat stroke.

Two groups of psychiatric drugs, antipsychotics and antidepressants have a significant impact on body temperature regulation. Schizophrenic patients on antipsychotic therapies have a much lower heat tolerance, with a higher possibility of developing hyperthermic syndromes such as febrile catatonia or neuroleptic malignant syndrome.

Antipsychotics have combined anticholinergic and central thermoregulatory effects. They can cause impairment of hypothalamic temperature regulation due to its antidopaminergic activity, which elevates the set point of temperature regulation centre. Moreover, they can also inhibit sweating. Both of these mechanisms lead to increased body temperature and higher risks of heat-related illnesses.

Elderly patients with polymorbidities: Various drug classes associated with hyperthermia are used more in the age group ≥60 years, resulting in polypharmacy in the elderly as a contributing factor for hyperthermia.

Stimulant drug users: Stimulants such as cocaine and amphetamine - in addition to faster heart rate, increased muscle activity and accelerated metabolism etc., they also have a direct effect on the thermoregulatory center (hypothalamus) resulting in an increase of body temperature. It is also a well-known effect that amphetamines cause severe dry mouth and thirst (which is exploited in some nightclubs by turning off the taps - more than one death has been caused by this "practice").