If you have recently started taking antidepressants and noticed that you are waking up sweating at night, you are not imagining things. Night sweats are one of the most common side effects of several widely prescribed antidepressants, and it is a side effect that catches many people off guard because it is rarely mentioned at the point of prescribing.
This guide covers why antidepressants cause night sweats, which medications are most likely to trigger them, whether the sweating tends to settle down over time, and what you can do to manage it without compromising your mental health treatment.
Why Do Antidepressants Cause Night Sweats?
Most antidepressants work by altering the levels of neurotransmitters in your brain, particularly serotonin and norepinephrine. These neurotransmitters do not just affect your mood. They also play a role in regulating your body temperature. When you change the levels of serotonin in your brain through medication, the hypothalamus (your internal thermostat) can be thrown off, leading to inappropriate sweating responses.
The mechanism is similar to what happens during menopause, where hormonal changes make the hypothalamus more sensitive to temperature fluctuations. In the case of antidepressants, it is the change in neurotransmitter levels that causes the recalibration.
A meta analysis of 76 randomised controlled trials involving 28,544 patients found that both SSRIs and SNRIs approximately triple the risk of excessive sweating compared with placebo (risk ratio of 2.93 for SSRIs and 3.17 for SNRIs). Clinical studies suggest that between 7% and 22% of people taking antidepressants experience sweating as a side effect, depending on the specific medication. Some studies put the figure even higher for certain drugs. It is one of the most underreported side effects because many people assume the sweating is caused by something else or are too embarrassed to bring it up with their doctor.
Sweating Risk by Antidepressant Type
| Medication | Type | Sweating Risk vs Placebo | Notes |
|---|---|---|---|
| Sertraline (Zoloft) | SSRI | Significantly increased | Among the most commonly reported for sweating |
| Fluoxetine (Prozac) | SSRI | Significantly increased | Longer half life, effects may take longer to settle |
| Paroxetine (Paxil) | SSRI | Significantly increased | May have slightly lower sweating risk than sertraline |
| Citalopram | SSRI | Significantly increased | Some evidence of slightly lower rates |
| Venlafaxine (Effexor) | SNRI | Significantly increased | Higher norepinephrine activity may increase risk |
| Mirtazapine | NaSSA | Variable | Some patients report less sweating than SSRIs |
| Bupropion (Wellbutrin) | NDRI | Not significantly increased | One of the lowest risk options for sweating |
| Fluvoxamine | SSRI | Not significantly increased | Lowest sweating risk among SSRIs |
Data from Beyer & Bhatt 2017 meta analysis of 76 trials (28,544 patients).
Sertraline and Night Sweats
Sertraline (sold under the brand name Zoloft in some countries) is one of the most commonly prescribed antidepressants in the UK, and night sweats are one of its most frequently reported side effects. If you search for sertraline side effects, sweating consistently appears near the top of the list.
Sertraline is an SSRI (selective serotonin reuptake inhibitor), which means it works by increasing the amount of serotonin available in your brain. The elevated serotonin levels can overstimulate the thermoregulatory system, causing sweating during the day and particularly at night when your body is supposed to be cooling down naturally.
For many people, sertraline night sweats are most intense during the first few weeks of starting the medication or after a dosage increase. As your body adjusts to the new serotonin levels, the sweating often reduces in intensity. However, for some people it persists for as long as they are taking the medication.
If your sertraline night sweats are tolerable and the medication is helping your mental health, the practical management tips later in this article can help you cope. If the sweating is severe and significantly affecting your sleep, talk to your GP about whether a dosage adjustment or a switch to a different medication might be appropriate.
Fluoxetine (Prozac) and Night Sweats
Fluoxetine, commonly known by its brand name Prozac, is another SSRI that frequently causes sweating. Like sertraline, it works by increasing serotonin availability, and the thermoregulatory disruption it causes follows the same pattern.
Fluoxetine has a longer half life than sertraline, which means it stays in your system for longer. This can mean that the side effects, including night sweats, take longer to settle down after starting the medication. On the other hand, the longer half life also means that missed doses cause fewer withdrawal symptoms, which is an advantage in other respects.
If fluoxetine is causing problematic night sweats, your GP may suggest trying a different SSRI, adjusting the timing of your dose (taking it in the morning rather than the evening can sometimes help), or adding a low dose medication to counteract the sweating.
Mirtazapine and Night Sweats
Mirtazapine is a different type of antidepressant (a noradrenergic and specific serotonergic antidepressant, or NaSSA) that works differently from SSRIs. While it is less commonly associated with sweating than the SSRIs, night sweats are still a recognised side effect.
Mirtazapine affects both serotonin and norepinephrine systems and also has antihistamine properties, which is why it tends to cause drowsiness and increased appetite as its most noticeable side effects. The norepinephrine component can contribute to sweating, particularly in the early weeks of treatment.
Some people actually switch to mirtazapine from an SSRI specifically because they experienced fewer sweating problems with it. Others find it causes sweating where their previous medication did not. Individual responses vary significantly, which is why working with your GP to find the right medication is so important.
Citalopram and Escitalopram
Citalopram and its newer relative escitalopram are both SSRIs that are widely prescribed for depression and anxiety. Both can cause night sweats, though some evidence suggests they may cause slightly less sweating than sertraline or fluoxetine. This varies significantly between individuals, so it is not a guarantee.
If you are currently taking either of these medications and experiencing night sweats, the same management strategies apply. Speak to your GP if the sweating is significantly affecting your quality of life, and do not adjust your dosage without medical advice.
How to Stop Night Sweats Caused by Antidepressants
The most important thing to say here is this: do not stop taking your antidepressant because of night sweats without talking to your doctor first. Stopping antidepressants abruptly can cause withdrawal symptoms that are far worse than the night sweats, and it can lead to a relapse of the condition the medication was treating.
That said, there are several approaches your GP might suggest.
Timing of your dose. If you are taking your antidepressant in the evening, switching to a morning dose can sometimes reduce night sweats. The medication's peak effect on your serotonin levels will occur during the day rather than during sleep. Your GP can advise on whether this is appropriate for your specific medication.
Dosage adjustment. Sometimes a slight reduction in dosage is enough to reduce sweating while still maintaining the therapeutic benefit. This should only ever be done under your doctor's guidance.
Switching medication. If the night sweats are severe and not improving, your GP may suggest trying a different antidepressant. Different SSRIs affect individuals differently, and a medication that causes sweating in one person may not in another.
Add on medications. In some cases, doctors prescribe a low dose anticholinergic or other medication to specifically counteract the sweating side effect. This is more common when the antidepressant is otherwise working well and switching is not desirable.
Managing Your Sleep Environment on Medication
While you work with your GP on the medical side, there is a lot you can do to make your nights more comfortable in the meantime.
Switch to breathable bedding. If your sheets are synthetic, they are making the problem worse by trapping heat and moisture. Natural fabrics like bamboo and eucalyptus wick moisture away from your body and are noticeably more comfortable on sweaty nights.
Keep your bedroom cool. Aim for 16 to 18 degrees Celsius. A fan for air circulation can help, especially during warmer months.
Wear loose, breathable sleepwear. Or less sleepwear. Natural fabrics only. Avoid anything tight or synthetic.
Maintain your bedding between washes. When you are sweating every night, the bacterial buildup in your sheets accelerates. A daily routine of airing your bedding and using a bedding hygiene spray keeps things fresh and hygienic without requiring you to wash your sheets every other day.
Use a silk sleep mask. If you use a sleep mask, make sure it is not synthetic. A silk sleep mask is naturally cooling and breathable, so it will not add to the overheating problem.
Stay hydrated. Drink enough water during the day. Dehydration makes sweating worse and can also affect the way your body processes medication.
For more comprehensive tips on managing night sweats regardless of the cause, see our full guide on how to stop night sweats.
