Medications and Heat Sensitivity!
I see a lot of posts about being careful in hot weather if you take certain meds, but I've always been confused about what exactly that looked like, so I thought I'd do some research and break it down. There's multiple ways meds can cause heat sensitivity, and how to manage it can depend on the cause.
I bolded the names of the meds so you can scroll through and find which ones apply to you. Specific info under the cut:
If you are taking a beta blocker (propranolol, atenolol, etc.), you are likely to have low blood pressure, which makes you more likely to pass out. You can help this by keeping up with hydration, wearing compression socks, and changing positions slowly (including when you get out of the water from swimming). You are also likely to sweat less, and the little blood vessels close to your skin won't expand as well for heat to dissipate, so you are more likely to over heat. You can help this by using fans and other cooling tools, and trying to stay indoors or at least in the shade in extreme heat.
If you are taking diuretics (diuril, thalitone, etc.), you might not feel as thirsty despite still needing hydration. Diuretics lower your blood volume, making you more prone to passing out from low blood pressure. You are also more likely to have an electrolyte imbalance. Symptoms of this might be confusion, irritability, diarrhea, constipation, fatigue, headaches, fast heart rate, muscle cramps, and nausea. How to treat electrolyte imbalance is above my level, but worth checking with your doctor or pharmacist about.
If you are taking a mood stabilizer (lithium), you are at risk for something called diabetes insipidus. This is when the fluids in your body are all out of balance, causing you to feel thirsty all the time despite drinking a lot of water, and have too pee a lot. These symptoms cause dehydration and being dehydrated, for any reason, can also lead to lithium toxicity. Symptoms of lithium toxicity include nausea, vomiting, diarrhea, stomach pain, confusion, shaking, new trouble with balance and coordination, muscle twitches, and eyes shaking. You need immediate medical help if this is happening. You are also more prone to electrolyte imbalance (see the paragraph before for more about this).
If you are taking antipsychotics (haldol, molindone, abilify, rexulti, vraylar, lauda, seroquel, etc.), your body is not going to be as good at regulating temperature and you might sweat less. This puts you at higher risk for heat exhaustion or heat stroke. You can help combat this by staying in the shade or inside, using a fan or other cooling tool (like a cooling towel or cold packs), and not exercising in the heat.
If you're taking an SSRI (zoloft, prozac, lexapro, etc) or SNRI (cymbalta, pristiq, effexor, etc.), you might sweat more, which makes you more dehydrated. You can help this by keeping up with water and electrolytes. SSRIs can also impact your overall ability to regulate your body temperature. You can help this by staying in the shade or inside, using a fan or other cooling tool (like a cooling towel or cold packs), and not exercising in the heat. You may also be more likely to get a sunburn. You can help this by wearing UV protectant clothes, wearing sunblock (and reapplying it often), and staying out of direct sun.
If you're taking a tricyclic antidepressant (amitripyline, amoxapine, doxepin, nortiptyline, anafranil, etc.), you are likely to sweat less and therefore be more likely to overheat. You can help this by staying in the shade or inside, using a fan or other cooling tool (like a cooling towel or cold packs), and not exercising in the heat. You may also be more likely to get a sunburn. You can help this by wearing UV protectant clothes, wearing sunblock (and reapplying it often), and staying out of direct sun.
If you're taking a stimulant medication for ADHD (ritalin, adderall, etc.), your body temperature might be higher to start, so it doesn't take as much time or heat for you to get too hot. You can help this by staying in the shade or inside, using a fan or other cooling tool (like a cooling towel or cold packs), and not exercising in the heat.
If you're taking a calcium channel blocker (things ending in -pine, plus verapamil and diltiazem), you are more prone to electrolyte imbalance. Check with your doctor about how to handle this. You're also at risk for low blood pressure, which makes you more likely to get dizzy when standing or pass out. You can help this by changing positions slowly and keeping up with hydration.
If you're taking one of these medications designed to lower blood pressure: ACE inhibitor (lotensin, vasotec, things ending in -pril), ARB (ending in -artan), sacubitril/valsartan, or nitrates:
Then you might have lower blood pressure, which makes you more likely to get dizzy or pass out when standing up. You can help this by changing positions slowly and keeping up with hydration. You may also feel less thirsty, even when you need more water.
If you're taking aspirin at a high dose, your blood vessels won't expand as much, which means it's harder for your body to cool itself down. This same problem happens with other anti-clotting meds (ADP inhibitors, dipyridamole, glycoprotein platelet inhibitor, cilostazol, vorapaxar). You can help this by staying in the shade or inside, using a fan or other cooling tool (like a cooling towel or cold packs), and not exercising in the heat. High dose aspirin can also make your body temperature higher to start, so it doesn't take as much time or heat for you to get too hot.
If you are taking topiramate, you are likely to sweat less and therefore be more likely to overheat. You can help this by staying in the shade or inside, using a fan or other cooling tool (like a cooling towel or cold packs), and not exercising in the heat. You might also pee more, which makes dehydration
If you are taking oxcarbazepine, you are likely to sweat more and pee more, both of which make you dehydrated. You can help this by keeping up with hydration.
If you are taking carbamazepine, you are more likely to feel dizzy in general, especially when you first stand up. Just knowing this can help so that can expect it might happen. Standing up slowly will also help.
If you are taking benadryl, dramamine, unisom, dimetap, tylenol PM, advil PM, scopolamine, ketotifen or other meds that are called anticholinergics, your body can't regulate its temperature as well. You may also sweat less, which makes you even more likely to overheat. You can help this by staying in the shade or inside, using a fan or other cooling tool (like a cooling towel or cold packs), and not exercising in the heat.
If you are taking certain antibiotics (bactrim, tetracyclines) or acne medications (accutane, benzoyl preoxide, salicylic acid, retin-A, etc) you are more likely to get sunburned. You can help this by wearing UV protectant clothes, wearing sunblock (and reapplying it often), and staying out of direct sun.
If you are taking the birth control pill, you might be more likely to a get a brown, blotchy rash while out in the sun. You can help this by wearing sunblock and UV protectant clothes.
If you are using a medication patch, the sun can change how quickly your medication is absorbed. Putting the patch on sunburned skin can also change how quickly its absorbed. This could mean you wind up with a higher dose than usual- check with your doctor about this one.
If you are taking NSAIDs (Advil, Tylenol, Aleve, etc.) you might be at higher risk for sunburn or other rashes from the sun. You can help this by wearing UV protectant clothes, wearing sunblock (and reapplying it often), and staying out of direct sun. The heat can also increase the impact of these meds on your kidneys and liver.
If you are taking thyroid replacement hormone (levothyroxine), you are likely to sweat more, which can make you dehydrated. You can help this by keeping up with hydration.
Of course, take your meds as your doctor tells you to! Just also check with them about how to stay safe in the summer.
Signs of heat exhaustion to watch out for include headache, fast heartbeat, fast breathing, dizziness, nausea, muscle cramps, and feeling faint. This can often be treated at home by lying down and cooling off.
Signs of heat stroke to watch out for include trouble breathing, confusion, dizziness, nausea and vomiting, throbbing headache, blurry vision, fast heart rate, passing out, and red, hot skin. This is a medical emergency!
Last but not least, here's my sources:
https://www.cdc.gov/heat-health/hcp/heat-and-medications-guidance-for-clinicians.html
Though 1 in 6 Americans take psychiatric medications, many aren't aware of the need to be mindful of the heat in summer months and how to av
Cleveland Clinic
Sun safety is always important, but sunscreen alone may not be enough to protect you if you take certain medications. There are dozens of ov
