Reporting on Adverse Clinical Events

A 41-year-old male schizophrenic patient developed hypothermia after receiving 2 doses of zotepine (total dose: 150 mg) on hospitalization. Prior to admission, the patient had been receiving flupentixol (12 mg/day), which was stopped due to lack of therapeutic benefit. On admission, his body temperature was 36.4°C, but reduced to 34°C after receiving 2 doses of zotepine. Additional symptoms included sinus bradycardia (52 beats per minute), hypotension (97/66 mm Hg), and a Glasgow Coma Scale score of 3. Laboratory screenings and a computed tomography scan of the brain did not reveal a specific cause. Treatment included transfer to an intensive care unit and the discontinuation of zotepine. Over a 9-day period in the intensive care unit setting, the patient’s status and body temperature gradually recovered. A switch in medication to amisulpride (800 mg/day) and olanzapine (20 mg/day) on separate occasions was not helpful. However, the patient did respond to clozapine (200 mg/day). The remainder of his hospital stay was uneventful, and the patient was eventually discharged to the long-term care facility that he resided in prior to admission. The authors concluded that this patient experienced drug-induced hypothermia related to zotepine based on the temporal relationship between the administration of the drug and the appearance and resolution of symptoms. They encouraged clinicians to be aware of hypothermia associated with antipsychotics including zotepine and that body temperatures should be monitored in patients with schizophrenia. Zotepine [“Losizopilon,” “Lodopin,” “Setous,” “Zoleptil”] Chen TR et al (WC Ouyang, Department of Psychiatry, Changhua Christian Healthcare System and Changhua Christian Hospital, Changhua, Taiwan; e-mail: d88904@gmail.com) Zotepine-associated hypothermia in a schizophrenic inpatient. J Clin Psychopharmacol 37:367–368 (Jun) 2017