Now that temperatures are rising and summer is basically here, I’ve been seeing a lot of videos on TikTok and Instagram claiming that antidepressants and other psychiatric medications can increase your risk of heat exhaustion and heat stroke.
Most of the posts center on a specific type of antidepressant known as SSRIs (Selective Serotonin Reuptake Inhibitors). These medications treat depression by increasing the levels of serotonin in the brain. Commonly prescribed SSRIs include Celexa, Lexapro, Prozac, Paxil, and Zoloft.
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As someone who relies on storebought serotonin, I had to find out if these claims are true. To learn more, I reached out to Dr. Judith Joseph, M.D., M.B.A.
She’s a board-certified psychiatrist who was recently named a 2024 Black Health Hero by PopSugar.
Dr. Judith confirmed that SSRI antidepressants can affect the way our bodies respond to heat in multiple ways. First, she explained, “SSRIs (like Zoloft), along with other psychiatric medications, may impact the hypothalamus’s ability to regulate temperature in the body. They do this by modulating serotonin, norepinephrine, dopamine — neurotransmitters which are brain chemicals that change the way parts of the brain function.”
The hypothalamus is the part of your brain that’s often thought of as the brain’s control center. It’s in charge of everything from your body temperature and hunger cues to your moods and when you wake and sleep, and its goal is to keep your body’s systems in balance, aka homeostasis.
According to Dr. Judith, changes in neurotransmitters caused by SSRIs can have an effect on the hypothalamus’s ability to keep your body temperature in homeostasis, which can cause people taking antidepressants to overheat more easily.
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Additionally, she explained that these medications may also impact your body’s sweat response. “Certain SSRIs impact acetylcholine, which is a neurotransmitter, and this may impact the body’s ability to sweat in response to temperature changes, and this may impact the perception of heat and overheating.”
Sweating is one of your body’s go-to’s when it needs to cool down. If you’re not able to sweat when temperatures rise, you’ll feel hotter than someone else at the same temperature who’s sweating normally.
And there’s another way that antidepressants can change the way we handle the summer heat. Dr. Judith said, “SSRIs also change the way our body’s nerves perceive heat, and this may send signals from our skin nerves back to the brain in terms of thermal or heat regulation.”
Plus, if you take an SSRI, you might want to be extra careful in the sun because Dr. Judith said, “Some SSRIs may also make the skin more sensitive to light, and being in the sun for prolonged periods of time may cause skin sensitivity and overheating.”
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I was curious if other psychiatric medications can affect how we deal with the heat, so I asked Dr. Judith about that too. She replied, “Yes, some antipsychotic medications (risperidone, Haldol, quetiapine), some antianxiety medications like benzodiazepines (Valium, Xanax), and some SNRI antidepressants (such as Venlafaxine) and TCA antidepressants can also cause this (such as amitriptyline and nortriptyline).”
“Some stimulants for ADHD (Adderall and Ritalin) and antihistamines (Benadryl) may impact the body and its ability to regulate the body’s temperature. These medications may interfere with the regulation of brain chemicals called neurotransmitters which change the way the hypothalamus can regulate heat and temperature in the body.”
So how can you tell if you’re having a tough time in the heat? Dr. Judith says mild overheating can cause intense thirst and sweating, flushing, and turning red. You might also feel dizzy or lightheaded, experience nausea, or develop a headache. In some people, overheating can make their heartbeat race, in which case Dr. Judith recommends wearing a smartwatch that can notify you of changes in your heart rate.
If you’re experiencing mild overheating, Dr. Judith advised, “In these mild cases, you may want to lie down with your feet up, put icepacks on, and drink fluids. You may want to get out of the sun and into a cool area. You may not want to operate heavy machinery or drive. You may want to avoid alcohol and caffeine, which further dehydrate you.”
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More serious signs of overheating can include body temperatures of 103 and above, confusion and disorientation, vomiting, fainting, shortness of breath, rapid breathing, severe headache, problems seeing or talking, and even seizures. In these cases, Dr. Judith advised, “This requires you to go to the ER or call 911.”
“You may need an IV to rehydrate and medical-grade technology to cool down. You may need support for brain functioning to prevent death by seizure.”
Luckily, there are plenty of steps you can take to make sure the heat doesn’t sicken you this summer. Dr. Judith advised starting by making sure you have everything you need to keep your home cool and comfortable before it gets too hot. “Try to stay cool and hydrated, so check your air conditioning to make sure the filter is clean and that it is working before the weather gets hot so that it can get serviced by a technician.”
“Many people find out their AC doesn’t work in the middle of a heat wave and by then the technicians are fully booked because everyone is calling them. Purchase a new AC or cooling system before the hot months as they quickly become out of stock. Keep fans in storage and ready to use in the event of heatwaves.”
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Staying hydrated can also help your body handle higher temps, so Dr. Judith suggested, “Keep water and electrolyte drinks in stock and regularly hydrate.” Electrolytes can be found in sports drinks like Gatorade, products like Liquid IV, and beverages like coconut water.
You might also want to regularly check some of your vital signs so that you have a better sense of what’s normal for you, and so you know if anything changes. “Try to keep a first aid kit at home to check temperature regularly, check blood pressure, and check your pulse.”
She also shared some tips for enjoying the great outdoors in the hot summer weather. “Stay in the shade and avoid activities where you will be in the sun for hours without access to cooling fans or a respite from harsh and extreme temperatures. Keep ice packs in stock and take them with you.”
“For trips outdoors like camping and beach time where you are most at risk to overheat, plan ahead accordingly so that you are not in the sun for long stretches without a respite. You may want to identify cooling stations ahead of time and plan transportation.” You might also like to plan your outdoor activities in the morning before it gets too hot.
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If you’re concerned about how your medications might effect your ability to handle the heat, Dr. Judith recommended consulting with your doctor to better understand your personal risk. “Talk to your doctor about overheating as a symptom of your medications, especially when doctors prescribe multiple or new medications, so that you are aware of drug-drug interactions that may make overheating more likely.”
“If you have other medical conditions like seizures, low blood pressure, or heart arrhythmia, discuss this with your doctor as you may have drug-drug interactions between your psychiatric medications and your medical medications. Also, your pre-existing health conditions may make you more prone to overheating.”
Finally, she shared that heat can affect your mental health more than you might realize. “Heat impacts mental health and mental health symptoms. These psychiatric medications we discussed above are necessary for one in six Americans to have improved mental health conditions and improved quality of life. However, when overheating happens, this may also worsen anxiety, depression, mood, and thinking.”
“Overheating impacts physical and mental health, so anticipate that hotter months may impact your mood and psychological symptoms. Regularly look at the weather reports because a weather forecast can help you to forecast your mood so that you can reach out to your licensed professional for more support during extreme weather weeks. Overheating may worsen sleep, and good sleep and restorative sleep is necessary for improving depression, anxiety, attention, and cognition. So, minimize caffeine during hot weeks. Heat and temperature regulation should be taken seriously.”
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As someone who has benefitted tremendously from these types of medications, I’m a little bit shocked that nobody ever told me they could change how my body handles heat. But now that I know, I’m glad I have some more tips and tricks for getting through the summer without melting into a hot little puddle like the Wicked Witch of the West.
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