Heat Stroke in Phenothiazine-Treated Patients: A Report of Three Fatalities
SAMUEL ZELMAN M.D.1, and
RAMON GUILLAN M.D.2
1 Chief of medical service and assistant chief of staff for general medical and surgical services, medical and laboratory services, Veterans Administration Hospital, 2200 Gage Blvd., Topeka, Kans. 66622, lecturer in medicine, University of Kansas School of Medicine, Kansas City, Kans.
2 Chief of laboratory service, medical and laboratory services, Veterans Administration Hospital, 2200 Gage Blvd., Topeka, Kans. 66622
During a heat wave in July 1969, the authors encountered three fatal cases of heat stroke. All the patients had been treated with phenothiazines, which affect temperature regulation and suppress sweating, and two with anti-Parkinsonian agents, which also suppress sweating. The authors stress the need for lower phenothiazine dosages where possible, limited use of supplemental anticholinergic agents, and awareness of the susceptibility of phenothiazine-treated patients to the hazards of extreme temperatures.
