Which drugs cause excessive sweating? Exploring hyperhidrosis side effects

October 9, 2025 •

4 min read

According to research, selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants, can cause excessive sweating in up to 10–15% of patients. This side effect, known as drug-induced hyperhidrosis, can be a bothersome issue for many people taking a wide range of prescription and over-the-counter medications. So, which drugs cause excessive sweating, and what can be done about it?

Quick Summary

Many common medications across various therapeutic classes, such as antidepressants, opioids, and hormonal therapies, can induce excessive sweating. This is caused by a drug's effect on the central nervous system, neurotransmitters, or hormone levels. Effective management options exist, including dose adjustments or alternative treatments for the sweating itself.

Key Points

Antidepressants: SSRIs and SNRIs commonly trigger excessive sweating and night sweats by affecting the brain's thermoregulatory center.
Pain Relievers: Opioids and some NSAIDs can cause hyperhidrosis through mechanisms that involve histamine release and blood vessel dilation, respectively.
Diabetes Medications: Sweating while on diabetes drugs, such as insulin or sulfonylureas, is often a sign of hypoglycemia (low blood sugar), which can be a serious medical concern.
Hormonal Changes: Corticosteroids and breast cancer hormone therapies can cause sweating and hot flashes by disrupting hormone levels involved in temperature regulation.
Healthcare Consultation: If your medication causes excessive sweating, it is essential to speak with a healthcare provider before making any changes to your treatment plan.
Management Options: Treatment options for drug-induced hyperhidrosis include dose adjustments, switching medications, or using targeted therapies like prescription-strength antiperspirants or oral anticholinergics.

Medication-induced hyperhidrosis, or excessive sweating, is a relatively common but often under-discussed side effect of many prescription and over-the-counter drugs. For some, this can manifest as mild, occasional perspiration, while for others, it can be severe and disruptive, impacting daily life and sleep through drenching night sweats. Understanding the specific drug classes involved and the physiological mechanisms behind this reaction is the first step toward effective management.

Common Drug Classes That Cause Excessive Sweating

A wide array of medications can interfere with the body's thermoregulation system, leading to an increase in sweat production. The most frequent culprits include drugs that affect the central nervous system, hormone levels, or alter blood sugar.

Antidepressants

Antidepressants are among the most cited causes of drug-induced hyperhidrosis, with different classes affecting the body in various ways.

Selective Serotonin Reuptake Inhibitors (SSRIs): Common examples include sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro). These are frequently associated with excessive sweating, often due to their effect on the hypothalamus, the brain's 'thermostat'.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): Medications like venlafaxine (Effexor) and duloxetine (Cymbalta) can also trigger this side effect, with some having a risk comparable to SSRIs.
Tricyclic Antidepressants (TCAs): Though older and less commonly prescribed, TCAs such as amitriptyline (Elavil) can also cause sweating in some patients, though their overall anticholinergic effects can sometimes reduce sweating.

Pain Medications (Analgesics)

Both prescription and over-the-counter pain relievers can cause an increase in perspiration.

Opioids: Drugs like oxycodone (OxyContin), hydrocodone, and morphine are known to cause sweating. This is thought to be a result of stimulating mast cells, which release histamine.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): While used to reduce fever, drugs like naproxen (Aleve) and ibuprofen (Advil) can sometimes cause sweating by dilating blood vessels and dissipating heat.

Diabetes Medications

Sweating related to diabetes medications is often a symptom of hypoglycemia, or low blood sugar.

Insulin: A common symptom of low blood glucose caused by excess insulin is sweating, particularly during the night.
Sulfonylureas: These medications, including glyburide (Glynase) and glipizide (Glucotrol), can also cause hypoglycemia and subsequent sweating.

Hormonal Therapies

Medications that alter hormone levels can disrupt the body's temperature regulation.

Corticosteroids: Drugs such as prednisone can cause excessive sweating and hot flashes by mimicking the stress hormone cortisol, which regulates various bodily functions including metabolism and inflammation.
Breast Cancer Treatments: Hormone therapies like tamoxifen and aromatase inhibitors (e.g., anastrozole) can cause hot flashes and night sweats by lowering estrogen levels.

Understanding the Mechanisms of Drug-Induced Sweating

Excessive sweating from medication can be attributed to several different mechanisms within the body's complex thermoregulatory system.

Central Nervous System Effects: Many psychotropic drugs, like antidepressants and stimulants, influence the hypothalamus and sympathetic nervous system, which are responsible for regulating body temperature and the fight-or-flight response. This disruption can trigger sweat glands to become more active.
Neurotransmitter Imbalance: Some drugs alter the balance of neurotransmitters. For example, certain medications increase acetylcholine levels, a powerful stimulator of sweat production.
Hormonal Disruption: Steroids and hormonal therapies directly affect hormone levels that play a critical role in temperature control, leading to increased perspiration.
Hypoglycemia-Induced Adrenaline Release: For those with diabetes, an overdose of insulin or other glucose-lowering drugs can cause blood sugar to drop. This triggers the release of adrenaline, a key component of the body's stress response, which stimulates sweating.

Comparison of Medications and Their Risk for Excessive Sweating


Medication Class	Common Examples	Mechanism of Action	Risk for Hyperhidrosis	Common Presentation	Notes
Antidepressants (SSRIs/SNRIs)	Sertraline (Zoloft), Venlafaxine (Effexor)	Affects central thermoregulatory centers in the brain.	High (especially SSRIs/SNRIs).	Generalized sweating, night sweats.	Dose and individual sensitivity can vary the effect.
Opioids	Oxycodone (OxyContin), Morphine	Stimulates mast cells to release histamine.	High	Generalized sweating, skin warmth.	Sweating can also be a withdrawal symptom.
Hormonal Therapies (Steroids)	Prednisone	Alters hormone levels involved in temperature regulation.	Medium to High	Generalized sweating, hot flashes.	Often resolves after treatment course is completed.
Diabetes Medications (Insulin, Sulfonylureas)	Insulin, Glipizide (Glucotrol)	Hypoglycemia triggers adrenaline release.	High	Episodic, often accompanied by shakiness.	Sign of low blood sugar; requires checking glucose levels.
NSAIDs	Naproxen (Aleve), Aspirin	Dilates blood vessels to dissipate heat.	Low to Medium	Generalized sweating	Less common with as-needed use, more with chronic use.

What to Do If Your Medication Causes Excessive Sweating

If you believe your medication is causing excessive sweating, it's crucial to consult your healthcare provider. Never stop or change a medication's dosage on your own without professional guidance. Depending on the severity of your symptoms and the medical necessity of the drug, your doctor may suggest one of the following approaches:

Dose or Timing Adjustment: Sometimes, simply lowering the dose or changing when you take the medication can mitigate the side effect. For night sweats, taking the medication earlier in the day might help.
Switching Medications: In some cases, an alternative medication within the same class might be available that is less likely to cause hyperhidrosis.
Targeted Treatment for Sweating: If the drug is medically necessary and cannot be changed, your doctor may prescribe additional treatments for the sweating itself. These options include prescription-strength antiperspirants with aluminum chloride, oral anticholinergic agents like oxybutynin, or Botox injections for localized sweating.
Supportive Measures: Using breathable clothing and bedding, staying hydrated, and keeping your environment cool can also provide relief.

Conclusion

Excessive sweating can be a challenging side effect of many necessary medications, including those for depression, pain, and diabetes. The reaction is a result of a drug's interaction with the body's complex thermoregulation systems, involving neurotransmitters and hormones. While common, drug-induced hyperhidrosis is manageable. By working closely with a healthcare professional, individuals can explore options like dose modification, alternative drugs, or targeted therapies for sweating, allowing them to continue their necessary treatment while finding relief from this bothersome side effect.

For more detailed information on specific medications, consult the International Hyperhidrosis Society website.

Frequently Asked Questions

Yes, many antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are known to cause night sweats. This is due to their effect on the hypothalamus, the brain's temperature control center.

Yes, some over-the-counter pain medications, including NSAIDs like aspirin and ibuprofen, can cause sweating. This effect, though less common with occasional use, can occur due to their effect on blood vessels and body temperature regulation.

Sweating from diabetes medication, especially with insulin, is often a key symptom of hypoglycemia (low blood sugar). This can be a serious medical issue and requires checking blood glucose levels immediately and following your healthcare provider's instructions.

Opioids, such as morphine and oxycodone, can cause sweating by stimulating mast cells, which leads to the release of histamine. This can result in increased skin warmth and perspiration.

Yes, withdrawal syndromes from substances like alcohol and opioids can cause excessive sweating. This occurs as the body experiences compensatory sympathetic activation while adjusting to the absence of the substance.

You should speak with your healthcare provider. Do not stop or alter your medication dosage on your own. Your doctor can evaluate the situation and recommend a safe course of action, which may include adjusting the dose or switching to a different medication.

Treatment depends on the medication and individual. Options include dose reduction or adjustment, switching to an alternative drug, or prescribing treatments specifically for sweating, such as prescription-strength antiperspirants, oral anticholinergics like oxybutynin, or Botox injections for localized areas.