Meta-analysis: Risk of hyperhidrosis with second-generation antidepressants

Area of Science:

• Pharmacology
• Psychiatry
• Clinical Trials

Background:

• Hyperhidrosis is a common side effect of antidepressant medications.
• Quantifying this risk and understanding contributing factors is crucial for patient care.

Purpose of the Study:

• To quantify the risk of hyperhidrosis associated with commonly used antidepressant agents.
• To examine the impact of medication class, pharmacodynamics, and dose on hyperhidrosis risk.

Main Methods:

• A systematic literature search identified 76 double-blind, randomized, placebo-controlled trials.
• Random-effects meta-analysis assessed the pooled risk ratio of hyperhidrosis.
• Stratified subgroup analysis and metaregression explored medication-specific effects.

Main Results:

• 76 trials involving 28,544 subjects were analyzed.
• Most antidepressants significantly increased hyperhidrosis risk compared to placebo.
• Increased risk correlated with higher dopamine transporter affinity for SSRIs/SNRIs, but not dose.

Conclusions:

• Hyperhidrosis risk is elevated with most antidepressants, particularly those with higher dopamine transporter affinity.
• Fluvoxamine, bupropion, and vortioxetine did not show a significant increase in hyperhidrosis risk.