As climate change accelerates, summer is only getting longer – and hotter. Though the extreme heat can be difficult for anyone to deal with, it seems that it can be particularly arduous for people with certain mental health conditions.
During a recent heat wave, scores of people on TikTok posted about experiencing heat intolerance while taking serotonin reuptake inhibitors, also known as SSRIs, a type of antidepressant. The videos range from funny (relatable POV shots of people sweating profusely) to educational (some doctors weighed in on the medical reasons behind the phenomenon). It’s true that SSRIs can impact how your body reacts to heat, but as with anything on social media, the truth about SSRI heat intolerance is more complicated than it seems.
About 13% of adults in the United States take antidepressants (of which SSRIs are the most common form). SSRIs are commonly prescribed to treat depression, anxiety, and panic disorders and include commonly known medications like Prozac and Zoloft. The drugs function by blocking the brain’s reuptake of serotonin, which is a naturally occurring chemical that regulates mood. But regulating mood isn’t serotonin’s only job, says Dr. Joshua Wortzel, MD, a psychiatrist and assistant professor at the Yale School of Medicine.
“Sertonin plays a fundamental role in regulating the body’s main thermostat, the hypothalamus,” says Dr. Wortzel. “SSRIs [are] obviously going to have a number of effects on the body’s ability to thermoregulate. Ten percent of people on SSRIs will report increased sweating, especially in the beginning.”
Still, Dr. Wortzel says that SSRIs don’t necessarily lead to heat intolerance — it might be the mental health condition the drugs treat that changes how you react to heat. Research suggests that people with depression tend to have higher body temperatures, prompting scientists to look at whether lowering body temperature might have a therapeutic effect. Dr. Wortzel says increased sweating on SSRIs can be a cooling mechanism for the body, which helps regulate that core temperature.
So, do SSRIs cause heat intolerance? Not necessarily — but they do impact how your body regulates temperature, which we know can already be a struggle during the summer months. How can you handle all that sweating in the heat? Dr. Elizabeth Haase, MD, a psychiatrist who is part of the Climate Psychiatry Alliance, says it’s key to know your limits.
“The basic advice would be to be aware that you’re going to be less able to adapt to the heat than other people and to come in out of the heat earlier,” says Dr. Haase. “You just want to be more cautious.”
Dr. Haase stresses that the potential of heat intolerance should not keep someone from taking their prescribed medications. Instead, Dr. Wortzel says patients may reach out to their doctors to discuss SSRI heat intolerance and plan coping strategies.
“My number one advice would be to talk to your medical provider about how you’re going to manage your medicines in the heat,” says Dr. Wortzel. He notes that sleep is negatively impacted by rising temperatures and heat so if a person has to limit where they’re going to use air conditioning or other measures, it’s best to use it in the room where they sleep. “Air conditioning is huge because we know that sleep disruption can increase risks of depression, mood instability, emotional stability, and suicidality. Try to stay cool at night."
If you don’t have access to air conditioning, Wortzel also says that fans are helpful in managing hot temperatures and immersion in cool bodies of water is effective, though only for the length of time the person is submerged. He also advises knowing where your local cooling centers are — public places where you can access air conditioning, particularly during extreme heat. You can find state-by-state guidance here, but spaces like public libraries are great resources for accessing some cool air. Even going to a park can be helpful, as parks tend to be cooler than other outdoor spaces.
Signs that you may not be tolerating the heat well, especially if you are on SSRIs, include becoming dehydrated, stopping sweating, or getting a headache, Wortzel says. If you have concerns about how you’re tolerating the heat and what to do about heat intolerance related to medication, it’s best to contact your doctor.
