title: Heat intolerance induced by antidepressants.
abstract: A case in which prescription medications induced heat intolerance which led to heat stroke is presented. A subject who suffered from depression and was treated with fluoxetine HCL (prozac) and lithium carbonate was engaged in mild intermittent work for 4 hours under hot/dry climatic conditions (Ta = 37 degrees C, rh = 15%). The subject lost consciousness, was hyperthermic and suffered from disseminated intravascular coagulation. A year later residual cerebellar symptoms were still evident and severe atrophy of the cerebellar tissue was demonstrated in a CT scan. It is suggested that drug-induced heat intolerance was the predisposing factor that reduced the patient ability to sustain exercise-heat stress, and under the favorable environmental circumstances led to excessive heat accumulation which ultimately caused heat stroke. This is the first description, to our knowledge, of heat intolerance of a patient treated by a combination of fluoxetine and lithium carbonate.
authors.affiliation: Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Epstein
authors.forename: D
authors.initials: D
authors.lastname: Albukrek
authors.forename: B
authors.initials: B
authors.lastname: Kalmovitc
authors.forename: D S
authors.initials: DS
authors.lastname: Moran
authors.forename: Y
authors.initials: Y
authors.lastname: Shapiro
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects*; D001833:Body Temperature Regulation / Q000187:drug effects*; D004357:Drug Synergism; D005473:Fluoxetine / Q000009:adverse effects*; D018882:Heat Stress Disorders / Q000209:etiology*; D006801:Humans; D008094:Lithium / Q000009:adverse effects*; D008297:Male
chemical_list: D000928:Antidepressive Agents; D005473:Fluoxetine; D008094:Lithium