What drugs cause facial sweating in a 60-year-old female?

From the Guidelines

Facial sweating in a 60-year-old female can be caused by various medications, with the most likely culprits being antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, and paroxetine, as well as other medications like calcium channel blockers and beta-blockers. The medications that can cause facial sweating in this patient population include:

• Antidepressants like SSRIs (e.g., fluoxetine, sertraline, paroxetine) and serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine and duloxetine, as reported in 1 and 1
• Hormonal medications, particularly hormone replacement therapy used for menopausal symptoms
• Opioid pain medications, including morphine, oxycodone, and tramadol
• Certain blood pressure medications like calcium channel blockers (amlodipine, nifedipine) and beta-blockers (propranolol, metoprolol), as listed in 1 and 1
• Diabetes medications such as insulin and sulfonylureas, which may lead to hypoglycemia and present with sweating
• Antipyretics like acetaminophen and NSAIDs, which can paradoxically cause sweating in some individuals
• Cholinergic drugs used for conditions like myasthenia gravis or glaucoma, which stimulate sweat glands directly It is essential to note that the patient should consult her physician about potential medication adjustments rather than stopping any prescribed medications independently, as this can lead to adverse effects on morbidity, mortality, and quality of life, as implied in 1. Some key points to consider when evaluating the patient's medication regimen include:
• The potential for drug interactions and side effects, as reported in 1 and 1
• The patient's medical history and current health status, which can influence the risk of adverse effects from certain medications
• The importance of monitoring the patient's response to medication adjustments and making further changes as needed to minimize the risk of morbidity, mortality, and quality of life, as suggested in 1 and 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Drugs Causing Facial Sweating

• Antidepressants, including:
  • Selective serotonin-reuptake inhibitors (SSRIs) such as paroxetine 2
  • Tricyclic antidepressants
  • Venlafaxine 2

Management of Drug-Induced Facial Sweating

• Discontinuation of the offending drug 2
• Dose reduction of the offending drug 2
• Substitution with another antidepressant 2
• Addition of an agent to control sweating, such as:
  • Benztropine 2
  • Cyproheptadine 2
• Topical glycopyrrolate for craniofacial sweating 3, 4

Treatment Options for Hyperhidrosis

• Topical aluminum chloride solution for primary focal hyperhidrosis 3
• Topical glycopyrrolate for craniofacial sweating 3, 4
• Botulinum toxin injection for axillary, palmar, plantar, or craniofacial hyperhidrosis 3, 5, 6
• Iontophoresis for palmar and plantar hyperhidrosis 3, 5, 6
• Oral anticholinergics for severe cases of hyperhidrosis 3, 5, 6