As the weather continues to get warmer during the summer months, it is important to raise awareness of how certain medications can impact heat-related illnesses. Selective serotonin reuptake inhibitors (SSRIs), commonly prescribed for conditions like depression and anxiety, can potentially increase the risk of heat exhaustion and dehydration. This blog explores the different interactions SSRIs have with the heat and offers tips on how to manage these risks in healthy and safe ways.
How SSRIs Influence Heat Regulation
SSRIs work by increasing the levels of serotonin in the brain, which can also affect the way our bodies respond to a variety of physiological processes. For this blog, we will be focusing on the physiological effects SSRIs have on heat regulation. Serotonin plays an important role in controlling body temperature. When this becomes altered by the usage of SSRIs, it can lead to an interference within the body’s ability to properly regulate heat. Before reading on, it is important to note that anyone taking an SSRI experiences the side effects of it differently. Some of the following physiological responses may relate to you and some may not, because it is so vastly different for everyone. If you have any concerns with your medications please consult your appropriate healthcare provider/prescriber.
Research suggests that SSRIs may:
Impact Sweat Regulation and Patterns: Serotonin impacts the signaling pathway that triggers our bodies to sweat. SSRIs have the potential to impact sweat in very paradoxical ways. They can either cause someone to sweat excessively (hyperhidrosis), or they can lead to a decrease in the ability to sweat, causing a decrease in heat dissipation from the body. Sweating plays an integral role in our body’s ability to regulate temperature.
Inability to Regulate Core Body Temperature: The changes in serotonin levels that comes from the usage of SSRI medications can disrupt the part of our brain that helps us to regulate body temperature, the hypothalamus. The hypothalamus is located at the base of the brain and regulates homeostasis of multiple functions within the body. Here the function we are primarily focused on is the homeostasis of body temperature. This disruption can then cause the body to elevate its core body temperature, therefore increasing the risk of heat-related illnesses.
Affect Fluid Balances: SSRIs also have the potential to impact our body’s ability to balance fluids. It is not uncommon for the use of SSRIs to cause a disruption in thirst perception. Changes in serotonin levels can affect how the brain interprets signals related to fluid balance and hydration needs. This then results in an increase in urine output, drinking too much or too little water. According to a study in the, “Journal of Clinical Psychopharmacology,” roughly 10% of people who take SSRI medications experience increased thirst, which suggests dehydration.
Risks and Symptoms to Watch For:
For individuals taking SSRIs, it's essential to be aware of the signs and symptoms of heat exhaustion and dehydration:
Heat Exhaustion: This occurs when we aren’t able to cool ourselves down naturally. This typically happens when we sweat, but when sweating isn’t able to cool us down it results in heat exhaustion, which can also lead to heat stroke. Symptoms include: heavy sweating, weakness, dizziness, nausea, headache, and muscle cramps. If not addressed promptly, heat exhaustion can progress to heat stroke, a more serious condition.
Dehydration: Clinical reports and evidence suggest that some individuals on SSRIs may experience dehydration-related symptoms, such as dry mouth or reduced saliva production. Signs of dehydration include: dry mouth, dark urine, infrequent urination, fatigue, and dizziness. Severe dehydration requires immediate medical attention.
Practical Tips for Prevention:
To better maintain the increased risk of SSRIs on heat-related illness, the following are tips to remain vigilant during the peak summer months.
1. Stay Hydrated: Drinking plenty of water throughout the day helps to remain hydrated, especially when you don’t feel thirsty. It is important to continue drinking water consistently. On top of drinking water, it’s also important to ensure you’re drinking electrolytes. Electrolytes help to provide the needed minerals regular water doesn’t have. You can also get needed minerals that help you to remain hydrated through raw mineral salts. Limiting the consumption of sugary, alcoholic, and caffeinated beverages during the heat will help keep you hydrated. Or, you can find a balance between these kinds of drinks with liquids that will hydrate you. Some of my personal favorite recommendations for staying hydrated will be listed at the end of this blog.
2. Stay Cool: Staying cool in the hot weather can help to assist your body in regulating a more functioning and effective cooler core temperature. Wearing lightweight and loose-fitting clothing can help to ensure our body temperature doesn’t rise too high and maintain sweat patterns. Remaining in air-conditioned environments and taking cool showers whenever possible also helps when beginning to recognize the symptoms of dehydration or heat-exhaustion. This will help to bring body temperature back to a homeostatic level. For those with limited access to air-conditioned environments you may also find “Cooling Shelters” in your area.
3. Be Aware of Peak Heat Times: Limit outdoor activities during the hottest parts of the day (usually late morning to early evening). If you must be outside, take frequent breaks in shaded or cool areas. Most weather apps and websites will provide a graph displaying when the hottest times of the day will occur for each day.
4. Monitor Medication Effects: Pay attention to how your body responds to SSRIs in hot weather. If you notice unusual symptoms, consult your healthcare provider.
Recommendations of aforementioned products:
DripDrop: is a company that creates electrolyte packets to add to your water. These are the best tasting electrolyte packets I have found thus far after trying so many. They hydrate you much faster than other brands, offer vitamins other brands do not, and don’t have that heavy, thick taste of most electrolytes.
Redmond’s Fine Mineral Salt: Sprinkling a tiny bit of this salt into your water in the morning can help you produce vitamins and minerals needed to remain hydrated.
While SSRIs are valuable medications for managing mental health conditions, their effects on heat regulation can pose challenges during the summer. By understanding these potential risks and implementing preventive measures, individuals can enjoy the season safely. If you're taking SSRIs and have concerns about managing heat exposure, discussing strategies with your healthcare provider is crucial for maintaining your well-being.
By staying informed and proactive, individuals can navigate the summer months confidently, ensuring their health and comfort are prioritized alongside their medication regimen.
DISCLAIMER: If you or someone you know is concerned about hydration while taking SSRIs, consulting a healthcare provider for personalized advice is recommended.
Sources:
1. Effects of SSRIs on Heat Regulation:
- Raj SR, Robertson D. Blood pressure responses and thermoregulation in serotonin transporter knockout mice. J Appl Physiol (1985). 2011;111(3):825-831. doi:10.1152/japplphysiol.00321.2011.
- Lambert GW, Reid C, Kaye DM, Jennings GL, Esler MD. Effect of sunlight and season on serotonin turnover in the brain. Lancet. 2002;360(9348):1840-1842. doi:10.1016/S0140-6736(02)11737-5.
2. Symptoms of Heat Exhaustion and Dehydration:
- Centers for Disease Control and Prevention (CDC). Heat-related Illness. Available online: [https://www.cdc.gov/disasters/extremeheat/warning.html](https://www.cdc.gov/disasters/extremeheat/warning.html).
3. Practical Tips for Prevention:
- American Heart Association. Staying Hydrated - Staying Healthy. Available online: [https://www.heart.org/en/healthy-living/fitness/fitness-basics/staying-hydrated-staying-healthy](https://www.heart.org/en/healthy-living/fitness/fitness-basics/staying-hydrated-staying-healthy).
- Mayo Clinic. Heat Exhaustion: First Aid. Available online: [https://www.mayoclinic.org/first-aid/first-aid-heat-exhaustion/basics/art-20056651](https://www.mayoclinic.org/first-aid/first-aid-heat-exhaustion/basics/art-20056651).
4. General Information on SSRIs:
- National Institute of Mental Health (NIMH). Mental Health Medications. Available online: [https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml](https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml).
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