sweating with SSRI or SNRI

[soccrwz]

I have a patient on 60mg duloxetine, who finds it effective for mood and the patient's pain, but notes an embarrassing amount of sweat since starting the medication. Besides tapering it down, which I've seen some studies that say this is not dose related. The patient doesn't have any other medications with significant interactions. Do you add a medication like benzotropine 0.5 mg every other day to 1 mg/d, cyprohepatidine 4mg qday or BID, their are others as well. Apparently this happens in 22% patients on SSRI and SNRI. Any thoughts?

---

Members don't see this ad.

 

[lobelsteve]

Change med instead of adding med to treat a med.

 

[VA Hopeful Dr]

Its technically a class effect but I've had reasonable success just changing medications to something else in the same class.

 

[soccrwz]

venlafaxine also an offender per reports, any other SNRI/SSRI of choice you like? She needs something for mood and pain as well, I prefer SNRI over SSRI with these dual diagnosis as SNRI are more helpful for pain components; although wellbutrin can work for some patients due to its mix receptor properties and apparently less sweating side-effects

 

[10KHertz]

Try low dose Pamelor and titrate to effect.

 

[Orin]

Try adding a Clonidine patch for the sweating maybe?

You could try the Benztropine or other stuff

Improvement of Antidepressant-Induced Sweating with As-Required Benztropine

www.ncbi.nlm.nih.gov

You could just try to make bank with botox for sweating?

 

[soccrwz]

Patient has borderline BP, so clonidine a no go, apparently increases sweating threshold not severity; seems to be lots of data/reports for benzotropine for SSRI induced sweating. Regarding botox for sweating, really works for patients I've had several say they can't survive without it

 

[Baron Samedi]

Try low dose Pamelor and titrate to effect.

I typically use doses of 10-25mg of Pamelor(occasionally up to 50mg) and rarely see a significant mood effect at these doses. Maybe I'm being too cautious with my dosing?

 

[Ducttape]

sweating where?

no kidding, but last night I saw this product advertised... maybe it was on the internet:

Face

Pore-minimizing, sweat-absorbing shine stopper for face & forehead. Dermatologist Recommended Risk-Free, Money Back Guarantee Effective, Non-Irritating & Residue-Free Activated by Sweat Absorbing Powders

www.mycarpe.com

 

[10KHertz]

I typically use doses of 10-25mg of Pamelor(occasionally up to 50mg) and rarely see a significant mood effect at these doses. Maybe I'm being too cautious with my dosing?

Pain Med docs tends to be lower on the dosing spectrum. Psych will push TCA doses much higher. I get worried by orthostatic and palpitation issues in the elderly. In younger patients you can titrate more aggressively.

Are we sure this sweating isn’t a seratonin syndrome? Any supplements being used? St Johns wart, etc?

 

[PMR’s chill]

Look for other meds that are potentiating seratonergic effect. Flexeril... Zofran...Tramadol... supplements...might be easier to Get ride of those.