As temperatures soar to record highs across the United States, medical professionals are cautioning the millions of Americans who take antidepressants about the potential dangers of heatstroke.
This is particularly concerning because certain antidepressant medications can interfere with the body’s ability to regulate temperature effectively.
Tricyclic antidepressants, although less commonly prescribed due to their intense side effects, including insomnia, bed-wetting, and chronic pain conditions such as fibromyalgia, pose a risk as they hinder the body’s natural cooling mechanisms, such as sweating and prompting increased water intake to compensate. Multiple classes of these drugs can cause heat intolerance.
On the other hand, the more frequently prescribed selective serotonin reuptake inhibitors (SSRIs) can actually lead to increased sweating, which ironically still puts individuals at risk of heatstroke due to excessive fluid loss and dehydration.
Sertraline is a common antidepressant that belongs to a group of drugs known as SSRIs, or selective serotonin reuptake inhibitors
Some examples of tricyclics approved by the Food and Drug Administration (FDA) include amitriptyline (Elavil), nortriptyline (Pamelor), and protriptyline (Vivactil).
‘Tricyclic antidepressants can decrease sweating,’ explained Dr. Nial Wheate of the University of Sydney, Australia, in an interview with Insider. ‘They act as anticholinergics, which essentially block the production of sweat by the sweat glands.’
‘Sweating is crucial for cooling down the body, so without proper sweating, the regulation of body temperature becomes compromised, increasing the likelihood of overheating.’
Commonly prescribed FDA-approved SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
According to the Centers for Disease Control and Prevention, more than 10% of Americans use antidepressants, with a higher prevalence among women, where 18% have taken them within the past 30 days compared to 8% of men.
Alongside heat intolerance, antidepressants can cause several other side effects, as reported by the Mayo Clinic, including nausea, increased appetite, fatigue, insomnia, dry mouth, constipation, dizziness, restlessness, and erectile dysfunction.
Heatstroke occurs when the body can no longer effectively cool itself, leading to dangerously high body temperature due to prolonged exposure to direct sunlight.
Symptoms of heatstroke include confusion, altered mental state, slurred speech, lack of sweating, loss of consciousness, incoherence, excessive sweating, dry skin, seizures, nausea or vomiting, dizziness, headache, and rapid pulse.
If left untreated, heatstroke can result in permanent disability or death.
For individuals on tricyclic antidepressants, Dr. Wheate recommends having a fan nearby to aid in the evaporation of the limited sweat production.
Those taking antidepressants should prioritize hydration by consuming ample amounts of water and electrolyte drinks to replenish fluids lost through excessive sweating.
It is not advisable, however, to stop taking antidepressants solely out of concern for overheating. Dr. Wheate emphasizes the importance of managing depression as a higher priority.
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