Posted by Sunnely on July 31, 2000, at 19:28:49
In reply to extreme sweating when on SSRI's, posted by Steve2 on July 30, 2000, at 16:45:04
> Does this sound familiar to anyone: Whenever I'm on an SSRI or Effexor I have problems with extreme sweating.
The exact cause of antidepressant-induced sweating is unknown. Unfortunately, sweating is a relatively common side effect seen with selective serotonin reuptake inhibitors (SSRIs) and has been reported in 7% to 11% of patients treated with SSRIs and 12% of patients treated with Effexor, an antidepressant with the ability to inhibit the reuptake of serotonin and norepinephrine.The following is an anecdotal report of Effexor-induced sweating successfully treated with benztropine (Cogentin), an anticholinergic. This was the case of 48-year-old school teacher with depression who was nonresponsive to Prozac, Zoloft, and psychotherapy. She was treated with Effexor 75 mg three times daily with complete remission of her depression, but experienced severe and socially embarrassing sweating that she was compelled to stop the drug. She agreed to restart Effexor at 75 mg 2 times daily with benztropine added at 0.5 mg twice daily. Effexor was then increased to 75 mg 3 times daily with subsequent remission of her depression and no sweating.
The authors suggested that presumably, SSRIs (and Effexor) enhance sweating either indirectly by affecting the sympathetic system or directly by acting on the hypothalamus. In this case, they believed that benztropine most likely blocked the acetylcholine receptors on the eccrine sweat glands and thereby caused a reduction in sweating. They proposed a more detailed explanation of this effect as follows: The eccrine sweat glands are stimulated by the sympathetic nervous system; however, the postganglionic fibers that reach the muscarinic receptors on the end organ are cholinergic. The preoptic and anterior hypothalamic nuclei are the areas of the hypothalamus that contain heat sensitive and cold sensitive neurons and are mainly responsible for the stimulation of these sweat glands.
Other drugs suggested for antidepressant-induced sweating include clonidine (Catapres), an alpha-adrenergic agonist, and beta-adrenergic blockers such as atenolol (Tenormin).
It should also be noted that approximately 80% of menopausal women experience sweating, along with the usual "hot flashes."
Sources:
1] Garber A, Gregory RJ: Benztropine in the treatment of venlafaxine-induced sweating (letter). Journal of Clinical Psychiatry 1997;58(4):176-177.
2] Feder R: Clonidine treatment of excessive sweating (letter). Journal of Clinical Psychiatry 1995;56(1):35.
poster:Sunnely
thread:41772
URL: http://www.dr-bob.org/babble/20000729/msgs/41894.html