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tx of SSRI induced diaphoresis?

Discussion in 'Psychiatry' started by fiatslug, Apr 13, 2007.

  1. fiatslug

    fiatslug Senior Member
    Physician 10+ Year Member

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    (had perfect baby in December, she is amazing, wish I could drop out of residency and be a stay-at-home mom, but those damn student loan bills loom... :) )

    I have a pt who has had meaningful trials on virtually all the SSRIs (+ Effexor) and has experienced significant night sweats on all of them--class effect. However, they were all good for mood sx, and now that she's revealing some OCDish behaviors (picking at her eyes--yikes!), we'd both like to try her on an SSRI again.

    I'm finding very scanty literature on this--3 case based "letters to the editor," but that's it! Recommendations include Remeron as agumenting agent, Benztropine as augmenting agent, and Propranolol as a prn vs. qhs. Not finding a lot of data, so thought I'd troll for some real-life experience txing this side effect!

    Slug out
     
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  3. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
    Physician Moderator Emeritus SDN Advisor 10+ Year Member

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    What would you think about risperidone or ziprasidone as a primary agent?
     
  4. Anasazi23

    Anasazi23 Your Digital Ruler
    Moderator Emeritus 10+ Year Member

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    Most of my patients who experience this were either on other CYP-450 modulating meds or were simply very sensitive to medication effects.

    Have you tried to maintain on a small, small dose? i.e. 5 of lexapro?
     
  5. MBK2003

    MBK2003 Senior Member
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    This is the list of possible treatments (anecdotally all have some evidence for helping some patients) for SSRI-induced sweating provided by my psychopharm guru listserv.

    terazosin ( Hytrin) 1-10 mg QD
    oxybutyrin up to 5 mg po bid
    clonidine 0.1 mg bid
    guanfecine 2 mg po hs
    benztropine 0.5 mg po hs

    MBK2003
     

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