ALERT! Antipsychotics and Summer.

Many people in America today are taking antipsychotic medications to help reduce psychiatric symptoms. Family practice doctors and psychiatrists are using stronger medications for psychiatric and somatic complaints. For example, doctors are giving Abilify for mood stabilization. (Before the FDA approved this treatment) Abilify is an antipsychotic drug. A similar example is that many doctors are giving antipsychotic medications for sleep. As you can see from these examples, antipsychotics are given to the general population; these meds are not limited to just psych patients anymore.

Examples of antipsychotic medication are: Haldol, Thorazine, Sparine, Prolixin, Mellaril, Serentil, Trilafon, Stelazine, Taractan, Navane, Moban, and Loxitane. These medications are about 40 years old. Some of these medications are still used today, mostly in emergencies instead of long term treatment due to their heavy and dangerous side effect panel.

Examples of Atypical Antipsychotics are Clozaril approved by the FDA in 1990, Risperdal approved by the FDA in 1994, Zyprexa was approved by the FDA in 1996, Seroquel was approved by the FDA in 1997, Geodon was approved by the FDA about 8 years ago, and Abilify was placed on the market about 5 years ago. While some side effects to these newer drugs can be severe they are generally better tolerated for long term care.

While the list of the side effects is long, I will focus on summer time precautions. For the entire list see the article entitled  “Antipsychotic Medication.”

Photo-sensitivity. Use sun block and wear a big floppy hat! You can get a sun burn very easily. That coupled with the potential inability to perspire you got yourself a death stew. Plan outside events carefully. Protect your eyes by wearing sun glasses.

Decreased perspiration. Stay cool in the summer time. Drink plenty of fluids. This can be a very dangerous side effect which can lead to heat exhaustion or heat stroke. Note while on antipsychotic medication the body does not cool itself properly. You must keep this in mind while planning outdoor activities

WARNING! As stated above if you are on an antipsychotic you are more susceptible for heat exhaustion and heat stroke. You have to be doubly careful during hot summer days.

Heat exhaustion happens if the body gets too hot and hydration is not adequate. The symptoms of heat exhaustion are: heavy sweating, loss of color in the face, lethargy, weakness, muscle cramps nausea and vomiting, and fainting. The skin will be cool and moist. The pulse will be elevated and breathing will be fast and shallow.

Treatment for heat exhaustion is to cool the body. Drink water, lot’s of it. Get into some shade or air conditioning. The immediate goal is to cool the body.  One should rest after an episode of heat exhaustion. If this condition is left untreated one can progress into heat stroke which is completely life threatening.

Heat stroke is an elevated body temperature with accompanying physical and neurological symptoms. Put in simple terms, the body is unable to cool itself.  Heat stroke is a true medical emergency that can be fatal if not properly and promptly treated.

Common signs and symptoms of heat stroke include, high body temperature, the absence of sweating, with hot red or flushed dry skin, rapid pulse, problems breathing, strange behavior, hallucinations, agitation, disorientation, seizure, and coma.

People who experience heat stroke must receive immediate treatment to avoid permanent damage to the internal organs. First and foremost, cool the person. Get the person to a shady area, remove or loosen clothing, apply cool water to the skin for example, spray the person with cool water from a garden hose. Fan the person to help promote sweating and evaporation. Place ice packs under armpits and on the upper thighs close to the groin. Monitor body temperature with a thermometer and continue cooling efforts until the body temperature drops to 101-102 degrees. Notify emergency services (911) immediately. They can give you further instructions for treatment of the person. Don’t forget to help the affected person to drink lots of water and then something like Gatorade to replace the loss of electrolytes.

Important measures to prevent heat stroke are to avoid becoming dehydrated, to avoid vigorous physical activities in hot humid weather, and to plan ahead. If you have to perform physical activities in hot weather, drink plenty of fluids such as, water and Gatorade, but avoid alcohol, coffee, and tea which may lead to dehydration. Take frequent breaks to hydrate yourself. Wear hats, light colored and loose fitting clothing. Do what it takes to stay cool!

Tags: antipsychotics in summer time, heat exhaustion, heat stroke