I'm going to assume you're here for one of these reasons:

1. You’re currently taking ADHD medication or antidepressants.

2. You’re about to start one or both of these medications.

3. You're in the process of getting a diagnosis and you're researching antidepressant and ADHD medication side effects.

4. You know or take care of someone taking these medications.

   
   

But I'm sure the main reason you're here is because you heard that certain medications can cause excessive sweating and bad body odor. Keep reading to know which meds can cause this, why our bodies react this way, and if there’s anything we can do to stop sweating so much.

Why Do We Sweat?

Humans sweat as part of thermoregulation—the process of regulating body temperature. When you get too hot, sweating cools you down by evaporating moisture from your skin. This removes heat so you can maintain a comfortable internal temperature.

Some scientists believe that sweat may serve as a sort of “garbage disposal” to remove waste. However, the idea of sweat as an excretory mechanism hasn't been officially confirmed.

Where Does Sweat Come From?

Sweat is produced by three kinds of sweat glands:

1. Eccrine glands

2. Apocrine glands

3. Apoeccrine glands

   
   

Let’s explore these each more closely before we get into how the glands are affected by medications for ADHD, anxiety, and depression.

Eccrine Glands

Eccrine glands are the most common glands in the human body—we have millions of them. The sweat produced from eccrine glands is made of water and sodium (NaCl), so these are not the glands that cause bad B.O.

Most eccrine glands respond to temperature or heat. But the eccrine glands in the palms of your hands and soles of your feet (these are "glabrous glands," which just means there's a lot in one space) respond to both temperature and emotions, such as stress and anxiety.

Since these glands are literally everywhere, it's safe to assume that larger people have more eccrine glands. However, it's important to note that more sweat glands do not necessarily mean more sweat. 

How much a person sweats depends on sweat secretion rate per gland—not on the number of glands they have.

Apocrine Glands

Though they’re less abundant than eccrine glands, apocrine glands are much larger. They’re also inactive until you hit puberty, which explains why you probably didn’t notice your body odor until your tween or teen years.

Apocrine glands release sweat to a different part of the skin than eccrine glands.

While eccrine glands deposit sweat directly onto the skin, apocrine glands sweat into hair follicles through a process called "decapitation." Gland cells break off and release “thick” sweat made of proteins, lipids (fats), ammonia, and sugars.

Apocrine glands are only found in a few places on your body:

1. Armpits

2. Nipples

3. Groin area

   
   

Apoeccrine Glands

Lastly—and honestly kinda least—are the apoeccrine glands. These were discovered in the 1980's and not much is known about them.

Here's what we know about apoeccrine sweat glands:

1. Intermediate in size (larger than eccrine; smaller than apocrine glands)

2. Only found in the armpits (“axillary” area)

3. Release sweat onto skin surface (like eccrine glands)

4. Made of water and sodium (like eccrine glands)

   
   

That last point just screams, "I DON'T MAKE YOU SMELL BAD, OKAY?!" So, if it's alright with you, I'm going to move on to the good stuff.

Why Does Sweat Make You Smell Bad?

As mentioned, apocrine glands produce sweat that contains all kinds of delicious components: proteins, lipids, ammonia, and sugar.

😳 "Um did you just call ammonia delicious??"

Heck yeah, I did! But - I don't mean "delicious for humans." Gross.

I'm referring to bacteria. Quick refresher on microbiomes for those who need it - Our bodies are covered in microorganisms. We have millions and millions of bacteria cells living in and on our body—but they're good for us! If humans didn't have trillions of bacteria, we wouldn't be able to digest certain foods, and we'd be more susceptible to illness.

These good bacteria eat things from your body—like the food you ate for breakfast and that dead skin on the side of your nose. (Again, gross—I know. But bear with me. I promise this is going somewhere!)

Guess what else they eat?

Proteins, lipids, ammonia, and sugars - oh my! (If you recall, these molecules are also found in the sweat from apocrine glands!) But, what goes in must come out! (Or something like that.)

After eating these molecules, the bacterial organisms excrete gassy byproducts: the real cause of body odor. In other words, not only are you constantly covered in bacteria, but you're also covered in their burps and farts.

The Science of Sweating

Remember how eccrine glands respond to heat and emotions? Apocrine glands are different: They respond to adrenergic and cholinergic stimuli.

This means that certain signals from the nervous system can make apocrine glands produce more sweat, while other signals slow or stop sweating.

Fight-or-Flight Response

The “adrenergic stimuli” I mentioned above come from epinephrine (AKA adrenaline) and norepinephrine (AKA noradrenaline)—chemicals in your body that are released in response to fear or stress. This pushes you into "Fight, Flight, Freeze, or Fawn" response.

This has a few effects on your body:

1. You become more alert.

2. Your heart rate increases.

3. You blood pressure rises.

4. You feel less hungry. (Decreased appetite)

   
   

I'll talk about the connection in a minute. Before I get to that, let’s cover cholinergic stimuli.

Rest and Digest Mode

Cholinergic stimuli comes from acetylcholine. Put simply, acetylcholine does the exact opposite as adrenaline. When released into the bloodstream, acetylcholine puts you into “Rest and Digest” mode.

Acetylcholine has these effects on you:

1. Smooth muscle contraction - Your gut organs are made of smooth muscle; contraction of these muscles resumes digestion, causing your appetite to return, and the excretion of waste and fluid to begin again.

2. Heart rate decrease

3. Overall relaxation

   
   

(Acetylcholine also plays a role in other important things, such as memory and concentration, but that's a whole other thing that I can get to some other time.)

Antidepressants and Excessive Sweating

Depression and Anxiety

If you have depression and/or anxiety (both are very common in people with ADHD), you may take antidepressants. Research shows that people with depression and/or anxiety naturally have an overactive cholinergic system, which suppresses the adrenergic system.

In other words, people with depression or anxiety feel the way they do because their brain chemicals are out of whack. This imbalance can negatively impact their mood and how they handle stress.

How did scientists and pharmacologists combat this?

They developed antidepressants that target acetylcholine receptors, which block them from accepting excess molecules associated with the “Rest and Digest” mode.

As a result, the adrenergic system can finally function at a higher (i.e., "normal") level, allowing the body to produce and use more of the molecules that make us feel alert. Of course, there are other mechanisms and molecules at play here (such as serotonin), but for now, we're focusing on acetylcholine, epinephrine, and sweaty pits.

SSRIs, SNRIs, and Nonstimulant ADHD Drugs

Note: Not everyone taking ADHD medication uses stimulants! Nonstimulants are commonly prescribed, which do not stimulate the central nervous system. (More on this below!) The following information is about SSRIs, but it's also likely that NDRIs (norepinephrine and dopamine reuptake inhibitors; such as Wellbutrin or Bupropion) and other nonstimulants have similar effects on the body.

Do you remember what I said about apocrine glands being activated by adrenergic stimuli? TA-DA! Here's the connection between sweating and antidepressants!

Selective serotonin reuptake inhibitors, or SSRIs, are the most popular antidepressant drug class, specifically when treating anxiety and depression. SSRIs and other types of antidepressants work in part by slowing down acetylcholine production. When this happens in a person who normally has higher amounts of acetylcholine (i.e., depressed and anxious people), their body experiences a dramatic shift in neurotransmitter volume and activity.

When antidepressants block acetylcholine receptors, the adrenergic system increases activity. (Not too much, though. They just help balance the two systems.) This uptick can cause some serious sweating, which provides lots of yummy food to all the bacteria in your armpits and groin area.

And, as you’ve probably guessed, this causes lots of bacteria flatulence and smelly body odor.

☝️ Important note! Different drugs prompt a variety of responses in different people. We don't all respond to medications the same way. For example, some people sweat profusely on Lexapro and smell great on Zoloft. However, I'm the exact opposite.

ADHD Stimulants and Sweating

ADHD stimulant medications (such as Focalin, Vyvanse, Ritalin, etc.) work by stimulating your central nervous system, or CNS, which is - more or less - the hub for the adrenergic and cholinergic systems.

In other words, your CNS is responsible for...

• Secreting extra epinephrine and norepinephrine when prompted; and

• Eliciting a response to those heightened levels.

  
  

The effects I listed earlier when your body is in fight-or-flight mode? Those all come from your central nervous system.

So, when you take a simulant medication, the CNS responds by producing epinephrine and norepinephrine (and also dopamine, but again... that's a whole other topic that isn’t the focus here), which helps you feel more alert.

It also decreases your appetite and increases your heart rate as I mentioned earlier, both of which are commonly reported as side effects of prescription stimulant medication.

But wait, doesn’t this cause a problem??

Here's the thing: The increased production of epinephrine and norepinephrine from stimulant medications can lead to more sweat production from your apocrine glands. This is because these glands are activated by adrenergic stimuli, just like with antidepressants.

As a result, stimulant medications can also lead to excessive sweating and body odor. And just like with antidepressants, different stimulants affect everyone differently! For example, Adderall has never caused body odor for me, but Vyvanse definitely made me smell funky.

How to Manage Excessive Sweating Caused by ADHD Meds and Antidepressants

1. Stay Cool and Hydrated.

• Wear breathable clothing: Stick to natural fibers like cotton and linen, or moisture-wicking materials. Basically, dress like you’re about to hit the gym, even if you’re just hitting the couch.

• Hydrate! Drinking plenty of water helps regulate your body temperature and replenishes fluids lost through sweating. Not to mention, certain medications naturally dehydrate you, so drinking extra water is always a good idea if you’re medicated.

  
  

2. Use Antiperspirants.

• Pick the right product. Look for over-the-counter antiperspirants with high concentrations of aluminum chloride to help reduce sweating. Obviously, if you have sensitive skin (like me), test out different deodorants before investing in a large order.

• Apply it correctly. 💡 Little-known fact about using deodorant: Applying antiperspirant at night before bed actually makes it more effective the next day. Letting it sit overnight gives the ingredients time to work while your sweat glands are less active.

  
  

3. Shower Regularly.

• Keep your bits clean. Regular showers wash away sweat and bacteria, reducing the severity of body odor. You can also use an antibacterial soap to keep bacteria at bay.

• Dry off thoroughly. After bathing, make sure to dry your skin well to limit overgrowth of bacteria—especially in areas prone to sweating.

  
  

4. Talk To Your Doctor.

If sweating is a major issue and it’s negatively affecting your quality of life, consider talking about it with the healthcare provider who prescribed the medication. They may adjust your dosage or suggest an alternative treatment for ADHD that doesn’t make you feel like you’re melting.

And please remember: Everyone’s body is different! It’s okay to try out a few medications before deciding which on is best for you.

Additionally, your doctor may recommend things like prescription antiperspirants, Botox injections, or other medical options for excessive sweating or hyperhidrosis.

Let’s Wrap This Up.

Remember - Excessive sweating is a common side effect of antidepressants and ADHD medication and you’re definitely not alone in dealing with it! With a few adjustments and some trial and error, you can find ways to manage it and stay comfortable. If you’re ever unsure or need more advice, don’t hesitate to reach out to your healthcare provider.

Stay weird -

Sydni