Summer in New York City is truly something special. You’ve got the cheerful chaos of Central Park, children delighting in spraying water from fire hydrants, and those overpriced sandwiches from the deli that just hit the spot during picnics by the waterfront.
But let’s be real, it’s also sweltering. I don’t mean to be dramatic, but navigating the heat in a humid, subtropical NYC in summer—without a weekend getaway to the Hamptons—can feel like a scene out of Les Misérables.
As I stroll to work, with sweat pooling above my lip and a wet patch forming on my brow, I think, it could definitely be worse. I could be facing a panic attack, which used to be way too familiar for me, pre-medication.
Yet, it’s a bit ironic—what helps me hold it together in a packed subway also makes me feel like I’m trapped in a sauna, fully dressed.
For about ten years, I’ve been on an SSRI, a selective serotonin reuptake inhibitor, to manage my anxiety and depressive episodes. Medications like Zoloft and Prozac come with a long list of potential side effects, including weight gain, loss of sexual function, and insomnia, but one that’s quite bothersome is hyperhidrosis—excessive sweating.
Of the approximately 32 million Americans taking antidepressants, around 21 percent, or about 6.7 million people, deal with this annoying side effect, as noted by the International Hyperhidrosis Society. This extra sweating happens because SSRIs mess with how the body regulates temperature, causing it to go into overdrive.
According to Dr. Angela Downey, a family physician and host of a health podcast, these medications affect the hypothalamus, essentially the body’s thermostat. She likens serotonin to an orchestra conductor who’s cranked up the heat on your internal climate control—resulting in unexpected sweating, especially during warmer weather or at night.
What a trade-off. I might not endure panic attacks or feel constantly gloomy, but after just a short walk down 8th Avenue, I look like I’ve just emerged from the East River.
Hyperhidrosis is a relatively common side effect of SSRIs and a similar class known as SNRIs (serotonin-norepinephrine reuptake inhibitors), which include medications like Effexor and Cymbalta, as noted by Dr. Olalekan Otulana, a general practitioner and addiction medicine specialist in the UK.
SSRIs keep serotonin—the so-called “happy hormone”—available in the brain longer, which is meant to uplift mood and alleviate anxiety. SNRIs take it up a notch by preventing the reabsorption of both serotonin and norepinephrine, a hormone influencing emotional intensity, thereby increasing levels of both neurotransmitters to enhance mood.
Dr. Otulana explains that these drugs stimulate the body’s center for temperature regulation.
This can cause the body to feel warmer than it actually is, forcing sweat glands into action as a cooling mechanism.
Since the hypothalamus serves as the body’s thermostat, serotonin receptors there, when activated by SSRIs or SNRIs, can actually lower body temperature through increased heat loss, which includes sweating profusely.
SSRIs throw the brain into a serotonin flood, preventing the hypothalamus from interpreting temperature signals accurately. As a result, it misreads the situation and triggers sweating.
When norepinephrine is introduced through SNRIs, it compounds the resulting dysregulation, intensifying the impact on sweat glands.
Dr. Ashwini Nadkarni, a board-certified psychiatrist at a major medical center and a professor at Harvard Medical School, suggests that people experiencing this issue discuss their options with their healthcare providers. It might involve switching to a less sweat-inducing antidepressant, such as Vortioxetine.
She also recommends non-drug approaches like wearing light, breathable clothing, using fans, and staying well-hydrated.
When I think about it, I’ve cycled through various SSRIs and SNRIs throughout my struggles with mental health, and nobody ever pointed out that hyperhidrosis could be a potential side effect. They definitely warned me about experiencing a drop in libido, though.
Dr. Otulana notes that people tend to notice this particularly during summer, as baseline sweating due to heat is already heightened, and the drug effect makes it worse.
For some, this can be quite distressing, especially if it impacts their confidence at work or socially.
Honestly, nothing irritates me more than spending a lot on quality makeup only for it to slide off, leaving me looking like a surrealist painting the moment I walk into the office.
Dr. Darji emphasizes that this side effect is real—it’s not just in one’s head—and it can significantly affect one’s quality of life, sometimes prompting people to stop their medication, which is taken very seriously by physicians.
If sweating becomes too much to handle, it’s vital to consult a doctor before stopping any medication. They can help taper the dosage safely to avoid withdrawal symptoms.
Make sure to discuss these concerns with your doctor. They can help adjust the dose, consider switching medications, or perhaps add something to manage the sweating.
For millions, sweating through the summer (and even fall, winter, and spring) is a small trade-off for mental stability—or at least a semblance of it.
