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You’re probably going to feel like a hot, sweaty mess any time the temp climbs to stratospheric levels during a heat wave. But if you’re on an SSRI like Paxil or Zoloft, you may be extra miserable.
That’s because selective serotonin reuptake inhibitors (SSRIs)—some of the most frequently prescribed antidepressants in the world because they’re generally considered safe, effective, and easy to take—can cause heat intolerance. About 10% of people who take an SSRI say they sweat excessively during sweltering conditions.
SSRIs have anticholinergic properties, which means they inhibit the ‘rest and digest’ system, which controls, among other things, the sweating that cools us down, David H. Rosmarin, PhD, associate professor at Harvard Medical School and founder of the Center for Anxiety, tells SELF. If you’re on sertraline (Zoloft) paroxetine (Paxil), or venlafaxine (Effexor), heat sensitivity may be a particular problem, Dr. Rosmarin adds. (Tricyclic antidepressants like amitriptyline and nortriptyline, which are another type of med altogether, are also a biggie for this side effect.) Some people may also experience night sweats or hot flashes when they are taking SSRIs.
Feeling like you are roasting in an oven isn’t just annoying—it can be dangerous. Because SSRIs interfere with your body’s keep-cool abilities, you may be more susceptible to heat exhaustion and its more serious relative, heat stroke—a medical emergency of the 911 variety. Here’s what experts recommend you do during sweaty scenarios if you’re taking an SSRI.
What can you do if you’re suffering from SSRI-induced heat intolerance?
You already know to up your liquid intake when it’s hot out, but staying hydrated is even more critical if you’re feeling heat-sensitive. Some people also develop dry mouth while taking an SSRI, so keeping fluids up can help that too.
Just let your doc know if you feel like your cravings for water are suddenly higher than what’s normal for you. Some SSRIs, like citalopram (Celexa) or duloxetine (Cymbalta), can cause you to feel unusually thirsty. And though it’s rare, excessive thirst could up your risk of developing a condition called hyponatremia, in which sodium levels in the blood become out of balance because you are consuming too much water. Some people with hyponatremia don’t have any symptoms, but you might notice nausea, dizziness, headaches, and muscle weakness if your sodium levels are low.
Also known as water intoxication, it can happen with any excess fluid intake, but beverages with electrolytes—which are minerals like sodium and potassium that can be found in, say, sports drinks—are generally a better choice than water for avoiding hyponatremia in sweaty circumstances.
It sounds basic, but small changes can really help regulate your body temp: Drink your beverages ice-cold if you can, make a beeline for air conditioning during the hottest part of the day, and apply a cold cloth to your head or neck. Clothes made of light, breathable fabrics like linen or 100% cotton will be your best friend. Dr. Rosmarin is a fan of Thompson Tees, which have built-in sweat pads.
SSRIs increase your risk of some relatively dangerous things in hot weather, and you should be aware of what they look and feel like. One of them is heat exhaustion, which means your core temperature is climbing but is still under 104 degrees Fahrenheit. You might feel anxious, confused, dizzy, and light-headed. You may have hot, red skin; be sweating profusely but peeing less often; and have a rapid heartbeat, or even nausea and vomiting. If this happens, you need to cool down—fast—because it might progress to heat stroke, a potentially life-threatening situation that happens when your core temperature climbs to 104 degrees or higher. Heat stroke can lead to seizures, hallucinations, loss of consciousness, and organ failure. If you are experiencing severe symptoms like hot skin, slurred speech, confusion, and intense sweating or dry skin—all signs of heat stroke—call 911 right away.
Medications don’t work equally well for everyone, Dr. Rosmarin notes, and it’s possible the SSRI your doc prescribed isn’t the best fit for you. Landing on the right antidepressant can be a really individual process, he says: “We wish it were simple but it’s not.”
If your hot, sweaty symptoms started out of nowhere after taking a new SSRI, let your doc know. You might decide together that you’ll continue on your current meds if the heat isn’t bothering you too much, but there may also be another antidepressant they suggest you try to cool things off.
Whatever you do, don’t suffer in sweaty silence—you deserve to feel better, and your doctor’s job is to help you find a treatment plan that actually works. Hopefully, one that doesn’t make you feel like you’re at a literal boiling point all summer long.
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