Some antidepressants can affect how your body regulates temperature and hydration. Experts explain the risks, warning signs and how to stay safe when training in the heat
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As someone who has been on sertraline to help manage my anxiety for a few months, I was quite concerned when I started reading about how I needed to be extra careful in the sun because of the higher risk of over-heating.
The fact I had been feeling hotter than ever before could have been my mind playing tricks on me, particularly as temperatures in the UK have been at an all-time high.
That said, armed with this warning – that I’d seen all over social media – I decided to explore it further for two reasons: 1: I don’t trust platforms like Instagram and TikTok for medical advice and 2: if it was true, as someone who exercises outside a lot and who was suffering from the heat more than ever before, I wanted to understand was this factual information or scare-mongering.
The only way to know was to ask the experts.
“Many people are unaware that some antidepressants can make hot weather more difficult to deal with. The concern around sertraline and heat is factual, but it needs to be explained carefully rather than presented in a frightening way,” explained London GP Dr Thuva Amuthalingam.
“Some antidepressants, including SSRIs such as sertraline (Zoloft) and escitalopram (Lexapro) can affect how the body regulates temperature and fluid balance. This may make some people more vulnerable to heat-related symptoms, especially during very hot weather and if they are engaged in prolonged exercise.
“Women taking these drugs do not need to panic or stop their medication because of a heatwave. The sensible message is to be aware of the risk, stay well hydrated, avoid exercising in peak heat, wear loose clothing, keep cool where possible, and seek medical help if they feel confused, faint, very weak, unusually agitated, or develop symptoms such as a racing heart, high temperature or severe dizziness.
“It becomes scaremongering when the message implies that sertraline is dangerous in the heat for everyone. For most people, the medication remains safe and important. The key is practical heat safety, not stopping prescribed treatment without speaking to a doctor.”
So why do these drugs sometimes make hot weather more difficult to deal with? It all comes down to how such medications affect the way the body regulates temperature. Some also affect fluid balance in the body, as well as sweating.
Responding to high temperature
According to New Jersey based Dr. Lauren Grawert, Clinical Advisor of https://thegardenrecovery.com/ there are a number of factors that come into play.
“While many people consider antidepressants to primarily impact a person’s mood, there are several types of psychiatric medications that can also affect the way the body regulates its own temperature.
“Generally, selective serotonin reuptake inhibitors (SSRIs) like sertraline are believed to be relatively safe; however, it has been noted that these drugs can contribute to increased susceptibility to heat-related illness under certain conditions, specifically when engaging in strenuous activity, dehydrated, and/or experiencing extended sun exposure.
“This is because firstly serotonin is known to play a significant part in maintaining the body’s ability to regulate its temperature. The use of medications that interfere with serotonin signalling could potentially result in decreased efficiency of the body’s ability to respond to high temperatures.
“Secondly, SSRIs have been associated with alterations in electrolyte levels, specifically low sodium levels. Low sodium levels can decrease physical function and exacerbate symptoms from hot weather.
“My recommendation is to view excessive heat as additional physiologic stress. When you train outside while on antidepressants, monitor recovery closely.
“If a workout that normally feels manageable becomes accompanied by dizziness, excessive exhaustion, elevated heart rate, or difficulty in cooling yourself, you may be experiencing the combination of heat and medication stressing your body. Smaller adjustments in timing, intensity, and hydration can greatly reduce your risk.”
Stay hydrated
In agreement is Manchester-based GP Professor Helen Wall, who adds that some people taking SSRIs may also experience increased sweating, making them more vulnerable to fluid loss during periods of extreme heat.
“This becomes especially important for individuals who exercise outdoors. Physical activity already raises body temperature, and when combined with hot weather and medications that can affect hydration or heat regulation, the risk of heat-related illness can increase,” she pointed out.
“For people taking sertraline or other SSRIs, the key recommendations are to stay well hydrated, avoid exercising during the hottest parts of the day, wear lightweight clothing, and pay attention to symptoms such as dizziness, headache, excessive fatigue, nausea, or confusion. These can be early signs that the body is struggling to cope with the heat.
“Most people can continue exercising safely while taking SSRIs, but they should be mindful that their heat tolerance may be different during periods of extreme weather.”
The key factor for all women on these types of medications who are working out in hot conditions is to take preventative measures. Exercising at cooler times of the day is ideal and workout at lower intensities when in hotter conditions.
“Adequate hydration is essential,” insisted Dr. Allen Masry, Medical Director of the USA health centre https://www.allinsolutions.com/ – “You must keep drinking water to keep yourself well hydrated and pay close attention to warning signs which include unusual tiredness, confusion, vomiting, dizziness, or muscle cramps. These symptoms should not be taken lightly, and are a sign that you need to slow down, rest, and hydrate.
“Lastly, do not discontinue antidepressant medication because of a heatwave. The best course of action is to adjust your level of physical activity, amount of hydration, and level of heat exposure and continue with your prescribed medication unless told otherwise by your psychiatrist or medical provider.”
