As temperatures hit record highs across the US, doctors warn millions of Americans on antidepressants could be at risk of deadly heatstroke.
This is because certain antidepressants affect the body’s ability to regulate temperature.
Tricyclic antidepressants are an older class of drug that are prescribed less often due to more intense side effects, including insomnia, bed-wetting, and chronic pain conditions such as fibromyalgia.
They prevent the body from cooling down normally, such as by sweating and making you drink more water to compensate. And this heat intolerance affects multiple classes of these drugs.
However, the more common selective serotonin reuptake inhibitors (SSRIs) can actually make you sweat more. This still leads to heatstroke because when you swear too much, it can leave you dehydrated.
Sertraline is a common antidepressant is of 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 cause you to sweat less,’ Dr Nial Wheate of the University of Sydney, Australia, told Insider, ‘because they act as anticholinergics, which means they basically stop your sweat glands from producing sweat.’
‘We sweat to cool down, so if you’re not sweating then you can’t regulate your body temperature properly and you’re likely to overheat.’
Some of the most common FDA-approved SSRIs are citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
More than one in 10 Americans use antidepressants, according to the Centers for Disease Control and Prevention. They’re more common in women, 18 percent of whom have taken them in the past 30 days compared to eight percent of men.
In addition to heat intolerance, common side effects of antidepressants include nausea, increased appetite, fatigue, insomnia, dry mouth, constipation, dizziness, restlessness, and erectile dysfunction, according to the Mayo Clinic.
Heatstroke is where the body is no longer able to cool itself and a person’s body temperature becomes dangerously high due to a long amount of time exposed to direct sunlight.
Common symptoms include confusion, altered mental status, slurred speech, not sweating, loss of consciousness, incoherence, profuse sweating, dry skin, seizures, nausea or vomiting, dizziness, headache, and fast pulse.
When heatstroke occurs, the body’s temperature can rise to 106°F (41C) or higher within 10 to 15 minutes. Heatstroke can cause permanent disability or death if the person does not receive emergency treatment.
For those on tricyclic antidepressants, Dr Wheate suggested keeping a fan blowing on you so the limited sweat you are producing can easily wick away.
Those on antidepressants should focusing on drinking lots of water and electrolyte drinks to replace fluid lost through excess sweating.
It’s not advised, however, to stop taking antidepressants if you’re worried about overheating.
‘Managing your depression is more important,’ Dr Wheate said.
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