Summer Heat and Mental Illness: A Dangerous Combination

Much of Alabama is gripped in an early summer heat wave which has already sent the temperature over 100 degrees in some Alabama cities.  The Alabama Department of Mental Health has issued a special warning that highlights the danger that the heat wave poses for those people with mental illness.

Mental Health officials state that the mentally ill are more vulnerable to heat-related illnesses and death, citing information from a new British Journal of Psychiatry study.  According to the study, when temperatures exceed 90 degrees Fahrenheit, those diagnosed with mental illness and treated with psychiatric drugs have a 40 percent greater risk of heat-related death than the general population.

Dr. Timothy Stone, the Alabama Department of Mental Health’s medical director, stated that the medications  mental health patients take make them more susceptible to heat stroke and more likely to develop certain types of medication toxicities.  He added that while everyone needs to drink plenty of fluids on hot days, “it’s especially important for those with mental illnesses to stay hydrated.”

Medications are not the only reason heat poses more of a threat to people with mental illnesses.  According to Stone, people with mental illnesses may lack awareness of the heat, may not have access to air conditioning, and may be socially isolated.  He added that “these individuals sometimes don’t have anyone checking on them.”

To raise awareness of the problem of heat-related illness and death  of the mentally ill, Stone has written a report that lists some psychiatric medications that are associated with heat intolerance.  The report also provides more generic information about preventing heat-related problems and recognizing the danger signs.  The report steers those people who want more information on the subject to the Centers for Disease Control (CDC).

Psychotropic medications may impair the body’s ability to regulate it’s own temperature, thus creating the risk of a an individual developing excessive body temperature, or hyperthermia, which can be fatal.  During periods of high heat, temperatures 90 degrees and above, high risk individuals should try to keep as cool as possible by staying in air conditioned buildings, avoiding over exertion in the outdoors, wearing loose fitting, light colored clothing, and drinking plenty of fluids to stay hydrated.

There are many psychotropic medications that can impair an individual’s response to heat, and a few of the more common ones are:  Abilify, Elavil, Haldol, Risperdal, Seroquel, Thorazine and Wellbutrin.

The two forms of heat-related illnesses are heat exhaustion, the milder form, and heat stroke, the more serious form. 

Heat Exhaustion can occur in both active and sedentary individuals, and can happen suddenly and may be quite brief.  The warning signs of heat exhaustion are: heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea and fainting.  If a person displays these symptoms, he should be moved to a cooler place as soon as possible, given water or other liquids, encouraged to rest for a short time, take a cool shower or bath, and loosen or remove clothing.

Heat Stroke usually occurs during heat waves, and those individuals with chronic illnesses, whether it be mental or physical illnesses, are most vulnerable.  Heat stroke, if left untreated, can lead to death.  The warning signs of heat stroke are: confusion, dizziness, nausea, unconsciousness, high body temperature over 103 degrees, rapid, strong pulse, throbbing headache and red, hot, dry skin.  As soon as the signs of heat stroke are recognized, take immediate action by loosening or removing clothing, moving the person to a cooler place, cooling the victim with cool water, and calling emergency personnel.