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Excessive sweating with citalopram
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I've just gone back on citalopram after a few years off and have noticed i'm sweating a lot more now. From what I know it's a fairly common side-effect but wanted to know if anyone else is using citalopram(celexa) with this side-effect and how did it affect your Ironman training?
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Re: Excessive sweating with citalopram [triguy1981] [ In reply to ]
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I take Effexor and it has the same side effect. The excessive sweating is real- I lost six pounds during a twelve mile run yesterday. So I am pretty religious about weighing in before and after runs to ensure that I’m consuming 16-20 ounces of fluid per pound lost to replace. I also get night sweats from time to time, so I tend to weigh myself on those mornings to see roughly how much fluid I’ve lost and replace accordingly. I also take no cal electrolyte drink with me on runs over ten miles with a hand bottle that I can refill along the route if needed. Lastly, I supplement with zinc (in addition to the K, Na, Mg I get in my electrolyte or recovery drink) because it’s lost in sweat and plays a role in overall immunity. I am 100% serious when I say that the struggle to stay hydrated is real. I highly recommend that you do a Levelen sweat rate and composition analysis as well to see what you’re up against. I don’t race tris anymore, but I have been able to go 4:13 for 70.3 while taking Effexor in hot and humid conditions. Hope this helps and I wish you the best of luck!
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Re: Excessive sweating with citalopram [triguy1981] [ In reply to ]
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triguy1981 wrote:
I've just gone back on citalopram after a few years off and have noticed i'm sweating a lot more now. From what I know it's a fairly common side-effect but wanted to know if anyone else is using citalopram(celexa) with this side-effect and how did it affect your Ironman training?

I feel for you. This is a really tough side effect and unfortunately there is not much you can do to stop it from happening. I am on desvenlafaxine (but have been on citalopram) and have found I have had issues with both. My psych is an excellent clinical pharmacologist and has tried some medications that can potentially decrease the excessive sweating but they had additional side effects which meant they were just not practical. These days I still sweat a bucket load even in the colder weather. I probably underestimate what I lose in the water swimming as well (pools I swim in are heated).

I did IM last year for the first time and really suffered in the heat with it. I did formal sweat testing in the lead up to it and found I was losing 3l/hr of sweat when running just below threshold in 33 degree temps. If I was ever fast enough to make it to Kona I think I would struggle! The main IM race in my error is a notoriously hot race. I likely would do better in colder races where the sweat loss would not be so bad, but also don't enjoy racing in the really cold weather either!

In terms of advice....the last poster has it down pat really, not too much more to add to that. There is a fair bit of trial and error for IM, can get away with a lot more for a 70.3. Formal sweat testing can be super useful, especially for IM distances. Try and replicate race conditions as much as possible beforehand (ie heat and humidity) and practice running off the bike in those conditions. My target was a sub 10:30 and was well on for that after the swim and bike (sitting around 6:15) but the heat in the back end of the bike and coming out onto the run made it brutal.

Part of me would love to be free of these medications but that is no easy process when you have been on them for a number of years.
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Re: Excessive sweating with citalopram [triguy1981] [ In reply to ]
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I'm a psychiatrist and in your case, I might suggest my patient to try another antidepressant with different mechanism. However you may take the risk of decreased efficacy and maybe another new side effect you don't want....
Another way to deal with undesired side-effect if you only response well to citalopram is to keep the lowest effective dose as possible.


Anyway, I think you could discuss with your Dr about treatment choice if it really bothers you.

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Re: Excessive sweating with citalopram [saxo001navy] [ In reply to ]
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saxo001navy wrote:
I'm a psychiatrist and in your case, I might suggest my patient to try another antidepressant with different mechanism. However you may take the risk of decreased efficacy and maybe another new side effect you don't want....
Another way to deal with undesired side-effect if you only response well to citalopram is to keep the lowest effective dose as possible.


Anyway, I think you could discuss with your Dr about treatment choice if it really bothers you.

This is welcome and apt advice.
Personally, I have been stable on Pristiq and have not found it easy in the past to swap between agents, so I have just learned to live with it as it is better to have this side effect then the reduced efficacy of other medications.
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Re: Excessive sweating with citalopram [triguy1981] [ In reply to ]
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I have found that very low doses of citalopram ( 2.5 mg - 5 mg) have, in some folks, provided adequate clinical efficacy, without the aforementioned side-effects. In Texas summers, I commonly start folks at 5 mg, if they are active outdoors, and some do fine on that dose over time. Hope this helps.
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Re: Excessive sweating with citalopram [docdave1] [ In reply to ]
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docdave1 wrote:
I have found that very low doses of citalopram ( 2.5 mg - 5 mg) have, in some folks, provided adequate clinical efficacy, without the aforementioned side-effects. In Texas summers, I commonly start folks at 5 mg, if they are active outdoors, and some do fine on that dose over time. Hope this helps.

Out of interest, seeing as you have commented (and yes, appreciate you have limited clinical information to hand (I am a specialist as well, just not in this area)).....what other classes of medications would you look at for a major depressive illness +/- anxiety (that would not cause an increase in sweating)? I feel like I have run the whole gamut. Everytime we looked at alternatives I was put off by issues relating to weight gain.....The sweating in racing is fine....when I am onstage talking to 1500 people it is slightly more problematic.
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Re: Excessive sweating with citalopram [Amnesia] [ In reply to ]
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In my opinion, most modern antidepressant's mechanism is to elevate serotonin level(SSRI, SNRI), however elevated serotonin activity(aka efficacy) might disrupt thermo-regulatory effects on the hypothalamus (cause of excessive sweating?) and this is why many SSRI have side effect of hyperhydriosis. However among SSRI, some studies reported that fluvoxamine had lower risk of hyperhydriosis. And mirtazapine (another kind of antidepressant with different mechanism) was reported to reduce excessive sweating starting from low dose. But mirtazapine is not also perfect especially to athlete because of weight gain due to increased appetite...

Use of anticholingergic drug or antihistamine or clonidine to decrease sweating is possible but not a smart choice because these drugs also have their specific side effects too...

So in short, there might some other antidepressant you could try to avoid excessive sweating, but anyway like triathlon, you need to find the balance.


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Re: Excessive sweating with citalopram [Amnesia] [ In reply to ]
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Please research bupropion, as it works through the dopamine neurotransmitter axis. I find that it tends to help folks who have issues with serotonin-based drugs.
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Re: Excessive sweating with citalopram [docdave1] [ In reply to ]
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docdave1 wrote:
Please research bupropion, as it works through the dopamine neurotransmitter axis. I find that it tends to help folks who have issues with serotonin-based drugs.

Thanks for that. Interestingly I did try it in the early days to augment the traditional anti-depressant I was on. From memory I found it give me the jitters/left me a bit wired but that was a number of years ago. I might look at revisiting things...would be nice to transition over at some point when life is not in the way....
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Re: Excessive sweating with citalopram [triguy1981] [ In reply to ]
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Just throwing this out there but I’ve been taking Trintellix since it was first introduced many years ago. My doc said it had very few, if any side effects and I found this to be true. I’ve actually gone off of it cold turkey without side effects but realized that I need it. I was able to do two IM’s while taking it without any disruption to my training.

Team Zoot
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Re: Excessive sweating with citalopram [triguy1981] [ In reply to ]
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I am a psychiatrist. I don’t know why this works, but sometimes I find it helps to switch from the generic (citalopram, desvenlafaxine) to the actual brand name (celexa, pristiq). Your post seemed to imply that you don’t recall having this side effect the first time you were on it years ago — perhaps back then you were on the brand name and now you’re on the generic.
Last edited by: AndyCaleb: Oct 7, 20 18:54
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Re: Excessive sweating with citalopram [jeepguy2358] [ In reply to ]
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jeepguy2358 wrote:
Just throwing this out there but I’ve been taking Trintellix since it was first introduced many years ago. My doc said it had very few, if any side effects and I found this to be true. I’ve actually gone off of it cold turkey without side effects but realized that I need it. I was able to do two IM’s while taking it without any disruption to my training.

I have been prescribing anti-depressants for 30 years now and I don't think there is one that is effective that has few if any side effects. Some pts have no side effects but many have some no matter which one I use. I am glad your experience with Trintellix has been good. Sometimes in busy clinical practice we don't ask much about side effects or pts don't tell us. I would say that was the case for me in the first ten years. I was just super busy in an underserviced area struggling to meet the needs of too many pts. Celexa had no side effects for me but did nothing for depression. Effexor works well but has significant side effects.

They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

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Re: Excessive sweating with citalopram [AndyCaleb] [ In reply to ]
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AndyCaleb wrote:
I am a psychiatrist. I don’t know why this works, but sometimes I find it helps to switch from the generic (citalopram, desvenlafaxine) to the actual brand name (celexa, pristiq). Your post seemed to imply that you don’t recall having this side effect the first time you were on it years ago — perhaps back then you were on the brand name and now you’re on the generic.

That is interesting you say that. In Australia and NZ where I live and work you often don't have a lot of choice as to which generic you are given, sometimes the central purchasing agency just buys a set generic and it is commonly noted across a broad range of medications that people get all sorts of different responses to them. In my specialty (anaesthesia) we also see a bit of this happening. Globally the medicine supply chain is in a pretty dire situation at the moment....we commonly run out of medications that we use every day and then have to source other generics from weird and wonderful places....it is like one factory going offline can have massive interruptions globally....
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Re: Excessive sweating with citalopram [Amnesia] [ In reply to ]
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I am in general practice in Canada and we have the same thing. About a year ago we couldn't get ARBs for hypertension. At one point they were talking about a shortage of furosemide. Supply chains are just not very robust. It is kinda scary.

They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

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Re: Excessive sweating with citalopram [spockwaslen] [ In reply to ]
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spockwaslen wrote:
jeepguy2358 wrote:
Just throwing this out there but I’ve been taking Trintellix since it was first introduced many years ago. My doc said it had very few, if any side effects and I found this to be true. I’ve actually gone off of it cold turkey without side effects but realized that I need it. I was able to do two IM’s while taking it without any disruption to my training.

I have been prescribing anti-depressants for 30 years now and I don't think there is one that is effective that has few if any side effects. Some pts have no side effects but many have some no matter which one I use. I am glad your experience with Trintellix has been good. Sometimes in busy clinical practice we don't ask much about side effects or pts don't tell us. I would say that was the case for me in the first ten years. I was just super busy in an underserviced area struggling to meet the needs of too many pts. Celexa had no side effects for me but did nothing for depression. Effexor works well but has significant side effects.

I’ve tried many different antidepressants (had to because of insurance) and every single one had terrible side effects. I had a couple weeks where I was in between insurance companies and didn’t take my meds. I had terrible body aches and a fever, therefore asked a friend who is a drug rep for the company how long it stays in your system and he asked why. I told how I was feeling and his response was that’s what makes my job easy. For most people, it doesn’t have side effects. Turns out, I actually had mono! As I mentioned, I went off it cold turkey several times and never felt any adverse effects other than my depression returning. I’m very fortunate to have found this drug. Sorry to highjack the thread.

Team Zoot
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Re: Excessive sweating with citalopram [jeepguy2358] [ In reply to ]
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jeepguy2358 wrote:
spockwaslen wrote:
jeepguy2358 wrote:
Just throwing this out there but I’ve been taking Trintellix since it was first introduced many years ago. My doc said it had very few, if any side effects and I found this to be true. I’ve actually gone off of it cold turkey without side effects but realized that I need it. I was able to do two IM’s while taking it without any disruption to my training.


I have been prescribing anti-depressants for 30 years now and I don't think there is one that is effective that has few if any side effects. Some pts have no side effects but many have some no matter which one I use. I am glad your experience with Trintellix has been good. Sometimes in busy clinical practice we don't ask much about side effects or pts don't tell us. I would say that was the case for me in the first ten years. I was just super busy in an underserviced area struggling to meet the needs of too many pts. Celexa had no side effects for me but did nothing for depression. Effexor works well but has significant side effects.


I’ve tried many different antidepressants (had to because of insurance) and every single one had terrible side effects. I had a couple weeks where I was in between insurance companies and didn’t take my meds. I had terrible body aches and a fever, therefore asked a friend who is a drug rep for the company how long it stays in your system and he asked why. I told how I was feeling and his response was that’s what makes my job easy. For most people, it doesn’t have side effects. Turns out, I actually had mono! As I mentioned, I went off it cold turkey several times and never felt any adverse effects other than my depression returning. I’m very fortunate to have found this drug. Sorry to highjack the thread.

Don't be sorry to hijack the thread with your own experiences, this is what these threads are all about!!
I have tried the medication you have mentioned (goes by a different name here). Did not cut it for me, I think the side effect I had from it was a severe headache, which as always could have been due to something else. Glad all is going well for you at the moment. I think we all need to look out for each other more.
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Re: Excessive sweating with citalopram [Amnesia] [ In reply to ]
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Great thread. A question: it seems like the thread discussions and the noted experiences has centred on the side effect of excessive sweating. Is excessive sweating, in your minds, the same as heat intolerance? I imagine there are basic mechanisms that are common to both, but i thought Effexor or, for example, included only intolerance in its side effects. It seems like the two, as far as experiences for endurance athletes, are very different things: as a excessive sweater, i could race hot as long as i don’t booger my fluids. But with heat intolerance, i think i would shut down.

Also, in the case of excessive sweating or heat intolerance and anti-depressant meds, is there a linear relationship to doseage? I did about 100% more lying on the side of the road during long rides in early stages of heat exhaustion this summer than any time on my life,
And was curious if this was based on a dosage increase, or a hotter than normal summer.

Again, thanks to those earlier posters for such great information.
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Re: Excessive sweating with citalopram [triguy1981] [ In reply to ]
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No real advice as it's been covered well on this thread.

For some reason this thread triggered a memory. I believe there is a thread on ST from many, many years ago, >8 or 9 years ago, if memory serves me correct, about this topic.

You may want to do a google search to see if it can be found.

Brian Stover USAT LII
Accelerate3 Coaching
Insta

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Re: Excessive sweating with citalopram [davetallo] [ In reply to ]
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davetallo wrote:
Great thread. A question: it seems like the thread discussions and the noted experiences has centred on the side effect of excessive sweating. Is excessive sweating, in your minds, the same as heat intolerance? I imagine there are basic mechanisms that are common to both, but i thought Effexor or, for example, included only intolerance in its side effects. It seems like the two, as far as experiences for endurance athletes, are very different things: as a excessive sweater, i could race hot as long as i don’t booger my fluids. But with heat intolerance, i think i would shut down.

Also, in the case of excessive sweating or heat intolerance and anti-depressant meds, is there a linear relationship to doseage? I did about 100% more lying on the side of the road during long rides in early stages of heat exhaustion this summer than any time on my life,
And was curious if this was based on a dosage increase, or a hotter than normal summer.

Again, thanks to those earlier posters for such great information.

I would need to do a deep dive into the literature for some of this, but general information as follows:
1. The excessive sweating is different to heat intolerance. Imagine being in a meeting in a suit and coming out drenched in sweat. Imagine going for an easy run with mates and being the one that comes back with clothes soaked through whilst others have hardly raised a sweat. It is not so much a heat intolerance, more that you seem to sweat more commonly in situations when others would not, and then in warmer situations sweat earlier and more than others. It is probably similar to being an excessive sweater as such, not so much heat intolerance.
2. Linear relationship to dosage: I don't think so, but would need to look into it. In general, most people will be on a relatively small number of different doses, whilst the doses may increase significantly, to me this feels more like an on/off situation, or gradual on at low doses then full on.....I have not experienced more sweating as I have increased doses myself, but have never been on very low doses.

Personally for me, I have had formal sweat testing done pre IM to put a race plan in place. Long runs in summer are planned so that i know there is good access to water during the run. I hate carrying fluids on long runs so will have used salt tabs etc, or a concentrated bottle of stuff and then supplement with water. Even considered botox to the underarms at times when it has been a pain with business attire (decided to flag that as the sweat is coming from all over....).
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heat intolerance, antidepressants, and 1 in 6 ... [ In reply to ]
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Just bumping this thread as a PSA ... with the awareness that (1) it's stooopid hot out there (gestures 'everywhere' with arms) and this might be a factor for some of us these days, and (2) something like 1 of 6 of us (North Americans, irk) are on some kind of psychiatric medication, and this side effect might be even more acutely expressed among those that spend a lot of time outside.
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