SSRI's and Heat Intolerance

[Kizzie]

I never knew that SSRIs can cause heat intolerance.  All these years thinking I just overheated easily for whatever reason and it turns out thermoregulation can be affected by medication.  At least now I know why.

https://www.psychologytoday.com/ca/blog/two-takes-depression/202107/heat-intolerance-and-psychiatric-medications

[Bach]

Oh, gosh, I remember that from the three different times I was prescribed Zoloft back in the 90s.  The first time I took it was in winter and at the time, an interesting effect it had on me was that it made me very tolerant to cold.  It was one of the few things about taking Zoloft that I liked, because I had always been very sensitive to cold.  But then warmer weather came, and I was never very heat tolerant to begin with.  Zoloft made that worse, and I still have the increased sensitivity 25 years later. 

[Papa Coco]

Wow. Timely information. I was on Zoloft in 2005-2006. I've been suffering with heat intolerance ever since, but I've never made that connection. I'm locked inside my AC house right now because it's over 80 degrees F outside now. I can only stay in the heat outside for maybe a maximum of 20 minutes before I start to get sick; headaches, double vision, and a racing heart.  I've been blaming everything from my weight to "maybe I'm becoming diabetic."  DANG IT!  Everything I try to do to help my depression causes a whole new problem. This is insane!!!!

Time to do some research. Has anyone found a way to reverse the effects? 

[Papa Coco]

Kizzie,

Thank you for posting this article about thermal regulation and SSRIs.

The one thing that helps me navigate the world of living with depression/anxiety/CPTSD/etc, is keeping up with information. Knowledge is power. I was planning to call my Dr. to get checked for diabetes, but the SSRI effects seem to be legit. Reading this, and now knowing that there's a reason to stay indoors during the hottest parts of the day, helps me to willingly and diligently manage my hydration and keep myself cool. On a positive note, winters have been more pleasant for me lately. I wear shorts around 362-365 days a year. In 2020 I didn't wear long pants even once. I used to wear thermal undergarments beneath heavy insulated pants when I needed to go outside in December. Shorts are easier to wash on laundry day. Ha Ha. There is a positive side to this.

[Kizzie]

I've been taking one SSRI or another for almost 30 years and used to joke my temperature gauge was not functioning correctly because I was always so hot. Turns out I was right!  Who knew SSRIs can mess with your thermoregulation among other things? 

Apparently Zoloft is known to cause people to overheat (moreso than other SSRIs) but I haven't noticed it yet I suppose because I'm also in A/C whenever possible.

[Papa Coco]

I was on Zoloft 15 years ago for three years. I STILL can't handle heat. I sleep with the windows open now in the winter. My wife and I can no longer share a bedroom. I have to sleep in an icy cold room now and she has to be in a hot room with electric blankets on. I keep thinking it's because humidity is getting worse in Seattle, but the web continually reports that humidity levels have never changed in Seattle. So I have to assume it's my own thermoregulation that's causing the change.

I too live all summer long in AC.

I quit the SSRIs a long time ago, but it's starting to look like my thermoregulation problem is permanent.  Dang.

[Kizzie]

Dang is right Papa, I was so hoping my heat intolerance would reduce now that I am off SSRIs but from the sounds of it that's not going to happen. I'll dig around in the academic lit and see if there's anything about this. 

It may not sound like much of a problem to some people but when you can't go out because the heat makes you feel ill, can't travel places you'd like to see because of the heat, have to sleep in separate bedrooms because you freeze your spouse out, etc.,  it's yet another big price we pay when we have mental health issues like CPTSD. 

[Kizzie]

A bit of a mish mash of info.

Unfortunately I didn't find anything about whether our thermoregulation adjusts back once we're off SSRIs.   There are meds for treating sweating when you're on an SSRi but I don't know if they work once you're off -- benztropine or cyproheptadine (example Cyproheptadine for Drug-Induced Sweating - https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.159.5.874-a) 

General Articles

Can taking antidepressants put you at greater risk of heat stroke and dehydration?, By Lauren Geall

Some antidepressants may make heatwave challenging, By Annabel Rackham, BBC New, August 2022

Ways to stay safe if your psychiatric medication impairs temperature regulation in Mental Health Today, by Bryony Porteous-Sebouhian, 19 July 2021


Academic Articles

Cheshire, W. P., & Fealey, R. D. (2008). Drug-induced hyperhidrosis and hypohidrosis: incidence, prevention and management. Drug safety, 31(2), 109–126. https://doi.org/10.2165/00002018-200831020-00002

Epstein, Y., Albukrek, D., Kalmovitc, B., Moran, D. S., & Shapiro, Y. (1997). Heat intolerance induced by antidepressants. Annals of the New York Academy of Sciences, 813, 553–558. https://doi.org/10.1111/j.1749-6632.1997.tb51746.x

Ghaleiha, A., Shahidi, K. M., Afzali, S., & Matinnia, N. (2013). Effect of terazosin on sweating in patients with major depressive disorder receiving sertraline: a randomized controlled trial. International journal of psychiatry in clinical practice, 17(1), 44–47. https://doi.org/10.3109/13651501.2012.687449

Kolli, V., & Ramaswamy, S. (2013). Improvement of antidepressant-induced sweating with as-required benztropine. Innovations in clinical neuroscience, 10(11-12), 10–11.

Mago, R., Thase, M. E., & Rovner, B. W. (2013). Antidepressant-induced excessive sweating: clinical features and treatment with terazosin. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 25(3), 186–192.

Marcy, T. R., & Britton, M. L. (2005). Antidepressant-induced sweating. The Annals of pharmacotherapy, 39(4), 748–752. https://doi.org/10.1345/aph.1E564