For people taking antidepressants, summer heat can feel even more exhausting than it does for everyone else. When temperatures soar to 40 degrees Celsius (104 F) and above — as we have already witnessed this year in the Northern Hemisphere — this can affect how such drugs work, placing extra stress on our bodies.
“Some antidepressants … can affect how the body regulates temperature [and] sweating,” said the president of the British Royal College of General Practitioners, Victoria Tzortziou Brown. Symptoms can include “dizziness, nausea, headaches, tiredness or dehydration,” Brown said.
These are symptoms that I, too, experience when the thermometer approaches the 30 C mark. I’ve been suffering more heat-related problems since I started taking antidepressants about two years ago. Sertraline and amitriptyline are effective at treating my chronic pain, but they also make summer less enjoyable.
A picnic with friends in the park? Thanks for the invitation, but I can’t make it. I get dizzy whenever I do anything other than lie on the couch. Instead, I stay inside my darkened apartment, with a fan blowing air right into my face.
Even when it’s just 25 C, I often arrive at the office completely drenched in sweat. For me, headaches and constant exhaustion are as much a part of summer as tans and cocktails are for others.
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Increased heat sensitivity
“The human body maintains its core temperature through a complex system of physiological mechanisms that work together to compensate for fluctuations caused by metabolic processes, physical exertion and environmental factors,” said Michael Paulzen, deputy head of the psychopharmacology division at the German Society for Psychiatry, Psychotherapy and Psychosomatics. Paulzen is also chief physician at Aachen’s Alexianer hospital.
“A failure of this thermoregulatory process can be caused by thermal stress, heat or even certain medications,” Paulzen said.
These medications include antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), like sertraline, and tricyclic antidepressants, like amitriptyline. These medications affect the hypothalamus, a brain gland that regulates body temperature, among other things.
One possible consequence is that the body may struggle to regulate its temperature properly. This can lead to muscle cramps, fainting, heat exhaustion, and even heat stroke. Antidepressants can also reduce the sensation of thirst, meaning the body may require fluids before a person realizes they are thirsty. These medications can also make the skin more susceptible to sun damage.
“Some of these medications can make it harder for the body to stay cool and hydrated, so it is worth being mindful of drinking enough water and keeping out of the heat,” said Daniel Harwood, of Britain’s Royal College of Psychiatrists. “Becoming dehydrated can be a particular problem, as it can increase sensitivity to the effects of some medicines.”
More sweating?
“I sweat like an unsheltered farm animal,” one user commented on a sertraline-related post on the Reddit chat forum.
“Usually heatwaves suck anyways, but since starting sertraline earlier this year, it’s so much worse, it feels like I am melting no matter what I do or wear,” another wrote.
A post from June simply reads: “I am SO hot all the damn time, ever since I been taking Zoloft [the brand name for sertraline in the US], it’s actually debilitating.”
There are medical explanations for these effects. “Tricyclic antidepressants such as amitriptyline can inhibit sweating and thus impair cooling through evaporation,” says Paulzen. “On the other hand, [other] antidepressants can increase sweating by leading to increased activity of the sympathetic nervous system, the activating part of the autonomic nervous system.” Sertraline, for example, is notorious for increasing sweat, judging by Reddit.
Always consult a doctor
I can’t wait for summer to finally be over — I’m tired of excessive sweating, recurring heat rashes and total exhaustion. But unfortunately, human-induced climate change will make higher temperatures increasingly common in the future.
Europe is the continent that’s heating up the fastest. So how can people who rely on antidepressants protect themselves?
First things first: Under no circumstances should you simply stop taking your medication or change your dose without first consulting a doctor.
“Stopping antidepressants suddenly can cause withdrawal symptoms and may affect a patient’s mental health and well-being,” Brown said. “The advice for people taking antidepressants is the same sensible heat-health advice we would give more broadly: drink plenty of fluids [and] stay out of direct sunlight where possible.”
Paulzen said following such precautions should make it possible to take antidepressants without experiencing increased side effects. One should, however, seek medical or therapeutic help if severe physical problems or previously unknown mental symptoms arise.
Fortunately for me, it hasn’t been that bad for me so far. That said, I’m already eagerly awaiting the start of fall.
This article was translated from German
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