There’s truly nothing quite like summer in New York City. The vibrant sounds of birds in Central Park, children laughing as they play in the refreshing spray from open fire hydrants, and the joy of enjoying a $20 sandwich from a beloved deli while sprawled on a picnic blanket by the waterfront are quintessential experiences. Yet, let’s not ignore the glaring truth: summer in NYC can be sweltering, akin to the inside of a dog’s mouth. I don’t mean to be overly dramatic, but navigating the ever-warming subtropical climate of New York City in the summer, without the promise of a Hamptons escape on weekends, can feel like a scene from a modern-day Les Misérables.
As I make my way to work, sweat trickles down my upper lip and creates a small triangle of perspiration above my eyebrows. I remind myself that it could be worse; I could be grappling with panic attacks, a common struggle for me before starting medication. However, the very lifeline keeping me sane during crowded subway rides is also responsible for making me feel like I’ve been trapped in a sauna, fully clothed.
For nearly a decade, I have relied on an SSRI, a selective serotonin reuptake inhibitor, to manage my anxiety and depressive episodes. Common SSRIs include well-known medications like Zoloft and Prozac. However, among the myriad of side effects—ranging from gastrointestinal issues to sexual dysfunction—lies a particularly uncomfortable one: hyperhidrosis, or excessive sweating. According to the International Hyperhidrosis Society, approximately 21 percent of the 32 million Americans taking antidepressants—about 6.7 million people—experience this unwelcome side effect.
Excessive sweating is triggered because SSRIs disrupt the body’s internal temperature regulation, often leading to unnecessary perspiration. Dr. Angela Downey, a family physician and host of the Codependent Doctor Podcast, explains that SSRIs affect the hypothalamus, the brain’s thermostat. “Think of serotonin like an orchestra conductor who has suddenly turned up the volume on your internal HVAC system,” she states. “It can lead to unexpected sweating, especially at night or during warm weather.”
Excessive sweating is not exclusive to SSRIs; another class of medications called serotonin-norepinephrine reuptake inhibitors (SNRIs), which includes Effexor and Cymbalta, can also cause this side effect. Dr. Olalekan Otulana, a general practitioner and addiction medicine specialist in the UK, explains that while SSRIs increase serotonin levels in the brain, SNRIs also block the reuptake of norepinephrine, a hormone that influences emotional intensity. This combination can stimulate the body’s temperature regulation center, causing the body to perceive warmer temperatures and triggering the sweat glands to produce excess perspiration.
The hypothalamus, which regulates temperature, can become dysregulated due to the influx of serotonin from SSRIs or the combination of serotonin and norepinephrine from SNRIs. Dr. Ashwini Nadkarni, a board-certified psychiatrist, suggests discussing options with a healthcare provider to manage this side effect. Alternatives may include switching to a medication less likely to cause sweating, such as Vortioxetine, or exploring non-pharmacological strategies like wearing loose clothing made from breathable fabrics, utilizing fans, and maintaining hydration throughout the day.
Throughout my personal journey with mental health, I have tried various SSRIs and SNRIs and was never informed about the potential for hyperhidrosis. Psychiatrists often focused more on the risk of low libido. Dr. Otulana notes that many individuals notice this side effect more during the summer, as baseline sweating due to heat is already elevated. “For some, it can be quite distressing, especially if it affects confidence in work or social situations,” he remarks.
Dr. Uma Darji, a board-certified family medicine physician, emphasizes the importance of communication with healthcare providers regarding this side effect. “If sweating becomes unbearable, don’t stop your medication without consulting your doctor,” she advises. Healthcare professionals can help by adjusting dosages, switching medications, or incorporating additional treatments to manage sweating effectively.
For millions, enduring a sweaty summer (and fall, winter, and spring) is a reasonable trade-off for achieving emotional stability. As I navigate the streets of New York City, I remind myself that while excessive sweating may be an inconvenience, the benefits of mental wellness outweigh the discomfort.
