From the Guidelines
Yes, fluoxetine (Prozac) can cause hyperhidrosis as a side effect, as indicated by the most recent and highest quality study available 1. This occurs in patients taking the medication, making it a potential adverse reaction. Hyperhidrosis, or excessive sweating, typically affects the body and may occur during both day and night. The sweating is related to how Prozac affects serotonin levels in the brain, which plays a role in temperature regulation. Some key points to consider about fluoxetine and hyperhidrosis include:
- The medication can cause a range of side effects, including dry mouth, nausea, diarrhea, heartburn, headache, somnolence, insomnia, dizziness, vivid dreams, changes in appetite, weight loss or gain, fatigue, nervousness, tremor, bruxism, and diaphoresis 1.
- Potentially serious adverse effects include suicidal thinking and behavior, behavioral activation/agitation, hypomania, mania, sexual dysfunction, seizures, abnormal bleeding, and serotonin syndrome 1.
- If you experience troublesome sweating while taking Prozac, you should not stop the medication abruptly but instead consult your healthcare provider, who might suggest strategies such as using clinical-strength antiperspirants, wearing breathable fabrics, adjusting the dosage, or in some cases prescribing additional medications like anticholinergics to manage this side effect.
- For most people, the sweating side effect may diminish over time as your body adjusts to the medication, but for others, it may persist throughout treatment. It's essential to weigh the potential benefits of fluoxetine against the potential risks, including hyperhidrosis, and to closely monitor patients for any adverse effects, especially in the first months of treatment and following dosage adjustments 1.
From the FDA Drug Label
The overall profile of adverse events was generally similar to that seen in adult studies, as shown in Tables 2 and 3 However, the following adverse events (excluding those which appear in the body or footnotes of Tables 2 and 3 and those for which the COSTART terms were uninformative or misleading) were reported at an incidence of at least 2% for fluoxetine and greater than placebo: thirst, hyperkinesia, agitation, personality disorder, epistaxis, urinary frequency, and menorrhagia
- Hyperhidrosis is not explicitly mentioned in the provided text as an adverse event associated with fluoxetine.
- The text does mention other adverse events, but hyperhidrosis is not among them.
- Therefore, based on the provided information, it cannot be concluded that fluoxetine causes hyperhidrosis 2.
From the Research
Hyperhidrosis and Fluoxetine
- There is no direct evidence in the provided studies that fluoxetine (Prozac) causes hyperhidrosis.
- However, studies have shown that other selective serotonin-reuptake inhibitors (SSRIs) can cause excessive sweating as a side effect 3.
- One study suggests that SSRIs can both initiate and inhibit sweating, depending on the noradrenergic "tone" resulting from the interaction of noradrenergic and serotonergic neurons in the brain 4.
- Another study found that paroxetine, an SSRI, was useful in treating palmar-plantar hyperhidrosis, possibly due to its anticholinergic action or antianxiety effect 5.
- Treatment options for hyperhidrosis include topical aluminum chloride solution, topical glycopyrrolate, botulinum toxin injection, and oral anticholinergics 6, 7.
Related Studies
- A study on antidepressant-induced sweating found that excessive sweating has been associated with antidepressants, including tricyclic antidepressants, SSRIs, and venlafaxine 3.
- A review of hyperhidrosis management options discussed the use of topical anticholinergics, botulinum toxin injections, and oral anticholinergics as treatment options for focal hyperhidrosis 7.
- A hypothesis on the effects of venlafaxine and SSRIs on sweating suggested that the efficacy of these medications against sweating can be reconciled with their known side effect of causing sweating 4.