Context

Hyperthermia is defined as an elevation of core body temperature above the normal diurnal range of 36° to 37.5°C due to the body’s inability to maintain thermoregulation i.e. the body produces more heat than it can dissipate [1-4].

Although fever also results in an elevated core temperature, the mechanisms causing fever and hyperthermia differ. Fever occurs when the hypothalamus increases the core temperature threshold in response to an insult, pathogen or drug [2]. Fever can be effectively treated with antipyretics which act on the hypothalamus to reduce the elevated set-point [2]. Hyperthermia occurs as a result of the body developing a hypermetabolic state which leads to an increase in heat production and/or reduction in heat dissipation [2,3]. Antipyretics have no effect on reducing body temperature in hyperthermia as the hypothalamus set-point has not been altered [2].

There is a wide range of differential diagnoses for hyperthermia including environmental exposure, sepsis, CNS infection, endocrine causes and drugs [1]. Hyperthermia as a result of drugs or medication is uncommon and can be overlooked.

Drug induced hyperthermia

There are five syndromes of drug induced hyperthermia:

  • Neuroleptic malignant syndrome
  • Serotonin syndrome
  • Malignant hyperthermia
  • Anticholinergic syndrome
  • Sympathomimetic syndrome

Each of these will be considered in detail.

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