A Case Study of Prazosin-Induced Hypothermia

Danae DiRocco; Seshagiri Rao Doddi

doi:doi:10.11648/j.ajpn.20210903.17

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A Case Study of Prazosin-Induced Hypothermia

Danae DiRocco, Seshagiri Rao Doddi

Published in American Journal of Psychiatry and Neuroscience (Volume 9, Issue 3)

Received: 14 July 2021 Accepted: 16 August 2021 Published: 31 August 2021

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Abstract

A case report of prazosin-induced hypothermia in a treatment-naive patient with PTSD. A 65-year-old woman with bipolar disorder and nightmares resulting from previous traumas was admitted to an inpatient psychiatry unit for mixed state hypomania and depression with suicidal ideation. Prazosin 1mg was started to help manage nightmares and the patient developed asymptomatic hypothermia with a low of 33.5C after 5 days of therapy. After internal medicine and endocrinology consults and appropriate testing did not result in an explanation, prazosin was stopped and her temperature returned to normal. A rechallenge of prazosin again resulted in a temperature decrease and was then discontinued. Hypothermia is not a reported side effect of prazosin in humans, though one previous case study reports hypothermia with a 20mg total daily dose in the treatment of a patient with hypertension. Animal studies indicate two possible mechanisms of action including 1) increased heat dissipation from skin by inhibition of non-shivering thermogenesis and decreased metabolic rate and 2) temperature increases upon rapid eye movement sleep deprivation (REMSD) in rats by increasing noradrenaline. Prazosin modulates REMSD-induced changes in body temperature in rats by blocking the effects of noradrenaline in postsynaptic receptors. To our knowledge, this is only the second reported case of hypothermia induced by prazosin.

Published in	American Journal of Psychiatry and Neuroscience (Volume 9, Issue 3)
DOI	10.11648/j.ajpn.20210903.17
Page(s)	115-117
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

PTSD, Prazosin, Hypothermia

References

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[2]	Milroy E: Clinical overview of prazosin in the treatment of prostatic obstruction. Urol Int 1990; 45 (suppl 1): 1-3.
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[4]	Wollersheim H & Thien T: Dose-response study of prazosin in Raynaud's phenomenon: clinical effectiveness versus side effects. J Clin Pharmacol 1988; 28: 1089-1093.
[5]	Ahmadpanah M, Sabzeiee P, Hosseini SM, et al: Comparing the effect of prazosin and hydroxyzine on sleep quality in patients suffering from posttraumatic stress disorder. Neuropsychobiology 2014; 69 (4): 235-242.
[6]	Fletcher B. Taylor, Patti Martin, Charles Thompson, Judi Williams, Thomas A. Mellman, Christopher Gross, Elaine R. Peskind, and Murray A. Raskind. Prazosin Effects on Objective Sleep Measures and Clinical Symptoms in Civilian Trauma Posttraumatic Stress Disorder: A Placebo-Controlled Study BIOL PSYCHIATRY 2008; 63: 629–632.
[7]	Heather R Taylor, Maisha Kelly Freeman, Marshall E Cates Prazosin for Treatment of Nightmares Related to Posttraumatic Stress DisorderAmj Health Syst Pharm. 2008 Apr 15; 65 (8): 716-22.
[8]	Ismene L Petrakis, Nitigna Desai, Ralitza Gueorguieva, Albert Arias, Erin O'Brien, J Serrita Jane, Kevin Sevarino, Steven Southwick, Elizabeth Ralevski. Prazosin for Veterans with Posttraumatic Stress Disorder and Comorbid Alcohol Dependence: A Clinical Trial. Alcohol Clin Exp Res. 2016 Jan; 40 (1): 178-86 doi: 10.1111/acer.12926. Epub 2015 Dec 19.
[9]	M. A. Raskind, E. R. Peskind, B. Chow, C. Harris, A. Davis-Karim, H. A. Holmes, K. L. Hart, M. McFall, T. A. Mellman, C. Reist, J. Romesser, R. Rosenheck, M.-C. Shih, M. B. Stein, R. Swift, T. Gleason, Y. Lu, and G. D. Huang. Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans. n engl j med. February 8, 2018 378 (6): 507-17.
[10]	MAJ Christine Maura Daly, MC USA; LTC Michael E. Doyle, MC USA; Murray Radkind, MD, Elaine Raskind, MD; MAJ Colin Daniels, MC USA. Clinical Case Series: The Use of Prazosin for Combat-Related Recurrent Nightmares among Operation Iraqi Freedom Combat Veterans. MILITARY MEDICINE, 170, 6: 513, 2005.
[11]	Matthew R Dierks, Joseph K Jordan, Amy Heck Sheehan. Prazosin Treatment of Nightmares Related to Posttraumatic Stress Disorder. Ann Pharmacother Jun; 41 (6): 1013-7.
[12]	Elaine R. Peskind, MD, Lauren T. Bonner, MD, David J. Hoff, PA-C, and Murray A. Raskind, MD. Prazosin Reduces Trauma-Related Nightmares in Older Men with Chronic Posttraumatic Stress Disorder. J Geriatr Psychiatry Neurol 2003; 16: 165-171.
[13]	Leeuw PWD, Birkenhager WH. Hypothermia: a possible side effect of prazosin. BMJ. 1980; 281 (6249): 1181-1181.
[14]	Wollersheim H, Berden J, Thien T. Decreased rectal body temperature induced by different vasodilatory drugs. Neth J Med. 1989; Apr; 34 (3-4): 189-93.
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[16]	Zarrindast, M.-R., Sadeghi, S. and Sahebgharani, M. (2003), Influence of α-Adrenoceptor Agonists and Antagonists on Imipramine-Induced Hypothermia in Mice. Pharmacology & Toxicology, 93: 48-53. https://doi.org/10.1034/j.1600-0773.2003.930107.
[17]	Matuszek M, Szreder Z, Korolkiewicz Z: Effects of prazosin onmetabolism and body temperature in normothermic rabbits. Pol J Pharmacol Pharm 1986.

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APA Style

Danae DiRocco, Seshagiri Rao Doddi. (2021). A Case Study of Prazosin-Induced Hypothermia. American Journal of Psychiatry and Neuroscience, 9(3), 115-117. https://doi.org/10.11648/j.ajpn.20210903.17

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ACS Style

Danae DiRocco; Seshagiri Rao Doddi. A Case Study of Prazosin-Induced Hypothermia. Am. J. Psychiatry Neurosci. 2021, 9(3), 115-117. doi: 10.11648/j.ajpn.20210903.17

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AMA Style

Danae DiRocco, Seshagiri Rao Doddi. A Case Study of Prazosin-Induced Hypothermia. Am J Psychiatry Neurosci. 2021;9(3):115-117. doi: 10.11648/j.ajpn.20210903.17

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@article{10.11648/j.ajpn.20210903.17,
  author = {Danae DiRocco and Seshagiri Rao Doddi},
  title = {A Case Study of Prazosin-Induced Hypothermia},
  journal = {American Journal of Psychiatry and Neuroscience},
  volume = {9},
  number = {3},
  pages = {115-117},
  doi = {10.11648/j.ajpn.20210903.17},
  url = {https://doi.org/10.11648/j.ajpn.20210903.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20210903.17},
  abstract = {A case report of prazosin-induced hypothermia in a treatment-naive patient with PTSD. A 65-year-old woman with bipolar disorder and nightmares resulting from previous traumas was admitted to an inpatient psychiatry unit for mixed state hypomania and depression with suicidal ideation. Prazosin 1mg was started to help manage nightmares and the patient developed asymptomatic hypothermia with a low of 33.5C after 5 days of therapy. After internal medicine and endocrinology consults and appropriate testing did not result in an explanation, prazosin was stopped and her temperature returned to normal. A rechallenge of prazosin again resulted in a temperature decrease and was then discontinued. Hypothermia is not a reported side effect of prazosin in humans, though one previous case study reports hypothermia with a 20mg total daily dose in the treatment of a patient with hypertension. Animal studies indicate two possible mechanisms of action including 1) increased heat dissipation from skin by inhibition of non-shivering thermogenesis and decreased metabolic rate and 2) temperature increases upon rapid eye movement sleep deprivation (REMSD) in rats by increasing noradrenaline. Prazosin modulates REMSD-induced changes in body temperature in rats by blocking the effects of noradrenaline in postsynaptic receptors. To our knowledge, this is only the second reported case of hypothermia induced by prazosin.},
 year = {2021}
}

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TY  - JOUR
T1  - A Case Study of Prazosin-Induced Hypothermia
AU  - Danae DiRocco
AU  - Seshagiri Rao Doddi
Y1  - 2021/08/31
PY  - 2021
N1  - https://doi.org/10.11648/j.ajpn.20210903.17
DO  - 10.11648/j.ajpn.20210903.17
T2  - American Journal of Psychiatry and Neuroscience
JF  - American Journal of Psychiatry and Neuroscience
JO  - American Journal of Psychiatry and Neuroscience
SP  - 115
EP  - 117
PB  - Science Publishing Group
SN  - 2330-426X
UR  - https://doi.org/10.11648/j.ajpn.20210903.17
AB  - A case report of prazosin-induced hypothermia in a treatment-naive patient with PTSD. A 65-year-old woman with bipolar disorder and nightmares resulting from previous traumas was admitted to an inpatient psychiatry unit for mixed state hypomania and depression with suicidal ideation. Prazosin 1mg was started to help manage nightmares and the patient developed asymptomatic hypothermia with a low of 33.5C after 5 days of therapy. After internal medicine and endocrinology consults and appropriate testing did not result in an explanation, prazosin was stopped and her temperature returned to normal. A rechallenge of prazosin again resulted in a temperature decrease and was then discontinued. Hypothermia is not a reported side effect of prazosin in humans, though one previous case study reports hypothermia with a 20mg total daily dose in the treatment of a patient with hypertension. Animal studies indicate two possible mechanisms of action including 1) increased heat dissipation from skin by inhibition of non-shivering thermogenesis and decreased metabolic rate and 2) temperature increases upon rapid eye movement sleep deprivation (REMSD) in rats by increasing noradrenaline. Prazosin modulates REMSD-induced changes in body temperature in rats by blocking the effects of noradrenaline in postsynaptic receptors. To our knowledge, this is only the second reported case of hypothermia induced by prazosin.
VL  - 9
IS  - 3
ER  -

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Author Information

Danae DiRocco

Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA
Seshagiri Rao Doddi

Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA

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APA Style

Danae DiRocco, Seshagiri Rao Doddi. (2021). A Case Study of Prazosin-Induced Hypothermia. American Journal of Psychiatry and Neuroscience, 9(3), 115-117. https://doi.org/10.11648/j.ajpn.20210903.17

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ACS Style

Danae DiRocco; Seshagiri Rao Doddi. A Case Study of Prazosin-Induced Hypothermia. Am. J. Psychiatry Neurosci. 2021, 9(3), 115-117. doi: 10.11648/j.ajpn.20210903.17

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AMA Style

Danae DiRocco, Seshagiri Rao Doddi. A Case Study of Prazosin-Induced Hypothermia. Am J Psychiatry Neurosci. 2021;9(3):115-117. doi: 10.11648/j.ajpn.20210903.17

Copy | Download

@article{10.11648/j.ajpn.20210903.17,
  author = {Danae DiRocco and Seshagiri Rao Doddi},
  title = {A Case Study of Prazosin-Induced Hypothermia},
  journal = {American Journal of Psychiatry and Neuroscience},
  volume = {9},
  number = {3},
  pages = {115-117},
  doi = {10.11648/j.ajpn.20210903.17},
  url = {https://doi.org/10.11648/j.ajpn.20210903.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20210903.17},
  abstract = {A case report of prazosin-induced hypothermia in a treatment-naive patient with PTSD. A 65-year-old woman with bipolar disorder and nightmares resulting from previous traumas was admitted to an inpatient psychiatry unit for mixed state hypomania and depression with suicidal ideation. Prazosin 1mg was started to help manage nightmares and the patient developed asymptomatic hypothermia with a low of 33.5C after 5 days of therapy. After internal medicine and endocrinology consults and appropriate testing did not result in an explanation, prazosin was stopped and her temperature returned to normal. A rechallenge of prazosin again resulted in a temperature decrease and was then discontinued. Hypothermia is not a reported side effect of prazosin in humans, though one previous case study reports hypothermia with a 20mg total daily dose in the treatment of a patient with hypertension. Animal studies indicate two possible mechanisms of action including 1) increased heat dissipation from skin by inhibition of non-shivering thermogenesis and decreased metabolic rate and 2) temperature increases upon rapid eye movement sleep deprivation (REMSD) in rats by increasing noradrenaline. Prazosin modulates REMSD-induced changes in body temperature in rats by blocking the effects of noradrenaline in postsynaptic receptors. To our knowledge, this is only the second reported case of hypothermia induced by prazosin.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - A Case Study of Prazosin-Induced Hypothermia
AU  - Danae DiRocco
AU  - Seshagiri Rao Doddi
Y1  - 2021/08/31
PY  - 2021
N1  - https://doi.org/10.11648/j.ajpn.20210903.17
DO  - 10.11648/j.ajpn.20210903.17
T2  - American Journal of Psychiatry and Neuroscience
JF  - American Journal of Psychiatry and Neuroscience
JO  - American Journal of Psychiatry and Neuroscience
SP  - 115
EP  - 117
PB  - Science Publishing Group
SN  - 2330-426X
UR  - https://doi.org/10.11648/j.ajpn.20210903.17
AB  - A case report of prazosin-induced hypothermia in a treatment-naive patient with PTSD. A 65-year-old woman with bipolar disorder and nightmares resulting from previous traumas was admitted to an inpatient psychiatry unit for mixed state hypomania and depression with suicidal ideation. Prazosin 1mg was started to help manage nightmares and the patient developed asymptomatic hypothermia with a low of 33.5C after 5 days of therapy. After internal medicine and endocrinology consults and appropriate testing did not result in an explanation, prazosin was stopped and her temperature returned to normal. A rechallenge of prazosin again resulted in a temperature decrease and was then discontinued. Hypothermia is not a reported side effect of prazosin in humans, though one previous case study reports hypothermia with a 20mg total daily dose in the treatment of a patient with hypertension. Animal studies indicate two possible mechanisms of action including 1) increased heat dissipation from skin by inhibition of non-shivering thermogenesis and decreased metabolic rate and 2) temperature increases upon rapid eye movement sleep deprivation (REMSD) in rats by increasing noradrenaline. Prazosin modulates REMSD-induced changes in body temperature in rats by blocking the effects of noradrenaline in postsynaptic receptors. To our knowledge, this is only the second reported case of hypothermia induced by prazosin.
VL  - 9
IS  - 3
ER  -

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