By Rajnish Mago, MD (bio)
Excessive sweating or hyperhidrosis can be associated with several psychiatric and non-psychiatric medications. Antidepressant-induced excessive sweating (ADIES) can occur with all or almost all antidepressants including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and bupropion.
Really? Is this is a common problem?
Everyone asks me: is this a common problem? Well, we can look at a few different sources to estimate how often ADIES occurs.
The rates for ADIES with different antidepressants reported in the Physician’s Desk Reference (www.pdr.net) vary from 5% to 14% of patients on an SSRI or SNRI, which is at least twice as often as on placebo.
A meta-analysis of clinical trials of SSRIs found that about 10% of patients reported sweating as an adverse event.
Combining these two sources above, we can say that excessive sweating occurs in about 10% of patients on antidepressants.
A study in routine clinical settings but using systematic assessment for adverse events associated with a variety of antidepressants found excessive sweating in 8.3% (moclobemide) to 40% (bupropion) of patients.
Why ADIES is important
Besides being common, ADIES causes significant distress to patients and can cause functional impairment as well. Patients often have to make changes to their activities and lifestyle because of the excessive sweating.
ADIES can be bothersome to patients in a variety of ways: the clothes feeling and appearing wet, visible sweat that needs to be wiped off repeatedly, sweating so badly that droplets of sweat drop off the body. The sweating can make patients very uncomfortable, make patients irritable, and interfere with their sleep. In addition, it can be embarrassing, lead to patients avoiding going out, and cause patients to change their clothes repeatedly.
While there is little data on this, ADIES can lead to non-adherence with antidepressants in some patients. Treating ADIES, if treatment is needed, can have a positive effect on patients’ well being.
Next, please read about the *clinical features* and *management* of antidepressant-induced excessive sweating (ADIES) by clicking on the links under Related Pages below.
Mago R, Thase ME, Rovner BW. Antidepressant-Induced Excessive Sweating: Clinical Features and Treatment with Terazosin. Ann Clin Psychiatry. 2013;25(2):E1-E7. PMID: 23638448.
Mago, R. Glycopyrrolate for Antidepressant-Associated Excessive Sweating. J Clin Psychopharmacol. 2013;33(2):279-280. PMID: 23422382.
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