Prolonged hypothermia due to olanzapine in the setting of renal failure: a case report and review of the literature

Temperature dysregulation is an infrequent but previously documented adverse effect of antipsychotic medications. The majority of documented cases involve durations of hypothermia of less than 24 h. We present the case of a patient on therapeutic olanzapine for bipolar disease with dehydration from gastroenteritis leading to acute kidney injury in the setting of stage III chronic kidney disease, who presented with severe hypothermia of 31.2°C (88.2°F). He required active rewarming in the intensive care unit for a total of 9 days. This is the second case report of prolonged hypothermia from olanzapine in the setting of kidney disease. Clinicians should be aware that patients with renal dysfunction may be at increased risk for prolonged hypothermia from olanzapine.