Regardless, a history of night sweats should prompt the clinician to ask more questions about sleep. Regarding evaluation, a number of medical evaluation approaches to night sweats have been proposed over the years however there are no published studies regarding the accuracy or cost-effectiveness of these protocols. The most common approach is a thorough medical history and lab work to identify any potential underlying medical or psychiatric condition. Finally, there are very few published studies that have examined symptomatic treatment of night sweats, except in postmenopausal women.
A few case studies suggest the use of alpha adrenergic blockers such as benztropine, terazosin or clonidine to reduce night sweats in those taking an SSRI. Thioridazine or thalidomide may be effective for patients with terminal cancer and desloratadine may help for narcotic addiction related night sweats for those receiving methadone treatment.
All of the currently existing studies though are too small and underpowered to yield reliable conclusions according to a recent systematic review of the literature Mold et al, The good news is that nocturnal hyperhidrosis is not associated with adverse health outcomes when you control for the underlying medical conditions mortality.
In other words, night sweats may result in increased daytime fatigue, insomnia and stress, but night sweats themselves are not imminently deadly.
The first line of defense is to identify and treat any potential underlying cause. Additionally, there are some tips that might help reduce or alleviate night sweats.
By William Brim on Some of the conditions that are known to cause night sweats include: menopause tuberculosis the most common infection associated with night sweats endocarditis osteomyelitis HIV infection There is some evidence that the onset of night sweats could be a weak predictor of early progression to AIDS in a person with HIV. Keep a cool bedroom environment. Be aware of synthetic fibers used in your bed material or bedding.
Hyperhidrosis was less likely with medications that had lower affinity for this receptor. The authors hypothesized that these findings are due to the effects of dopamine on thermoregulation. The authors note that these findings must be interpreted with caution for several reasons.
First, they found evidence of publication bias for studies reporting significant differences between antidepressant treatment and placebo. Additionally, the different side effects rating protocols that were used across trials may also affect reported rates of hyperhidrosis, making it harder to compare the trial findings.
Future studies with standardized comparisons including hyperhidrosis rating scales or physiologic measures , head-to-head comparisons of different medications, and fixed dosages would help provide more conclusive results. These types of effects can lead to nonadherence with treatment, 3 worsening the prognosis. The present paper is based on the doctoral thesis completed by Zahra Sherafat. National Center for Biotechnology Information , U.
Journal List Neuropsychiatr Dis Treat v. Neuropsychiatr Dis Treat. Published online Sep Author information Copyright and License information Disclaimer. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Background Selective serotonin reuptake inhibitors are primarily used in the pharmacological treatment of patients experiencing a major depressive disorder.
Methods A total of patients experiencing a major depressive disorder mean age Results Over time, subjective sweating reduced significantly in the treatment group as compared with the control group. Conclusion Administration of oxybutynin successfully reduced excessive sweating in patients experiencing a major depressive disorder and treated with sertraline.
Keywords: oxybutynin, sweating, sertraline, major depressive disorders. Introduction Depression is a recurrent illness requiring use of antidepressants over prolonged periods of time to treat acute and severe episodes and to prevent further episodes of depression.
Methods and materials Sample A total of patients mean age Table 1 Demographic data, sertraline dose, and presenting site of sweating for oxybutynin and placebo groups. Open in a separate window. Abbreviation: SD, standard deviation. Procedure Using a quasi-randomized approach, the subjects were assigned either to a treatment group oxybutynin or to a control group placebo.
Subjective sweating To assess subjective sweating, patients completed the Hyperhidrosis Disease Severity Scale HDSS , 19 consisting of four levels of sweating, and participants ticked the box reflecting the respective grade of sweating: grade 1, sweating is never noticeable and causes no trouble in daily activities; grade 2, sweating is tolerable but sometimes interferes in daily activities; grade 3, sweating is barely tolerable and frequently interferes in daily activities; and grade 4, sweating is never tolerable and permanently interferes in daily activities.
Statistical analysis By considering the fact that sweating is reported to occur in Results Sweating at the beginning and end of the study Table 2 provides a descriptive overview of the distribution of the severity of sweating as determined by the HDSS score at the beginning of the study and 2 weeks later for the treatment and control groups. Table 2 Descriptive and inferential statistics of sweating severity before and after two weeks of administration of oxybutynin or placebo.
Influence of time, group, and gender on subjective sweating To compare possible time, group, and gender interactions further, HDSS means were calculated and used as the dependent variable, while time before versus after treatment , group treatment versus control group and gender male versus female were introduced as independent variables Table 3. Table 3 Sweating severity according to time before versus after treatment , group oxybutynin versus placebo , and gender males versus females.
Figure 1. Adverse effects Table 4 shows the descriptive and inferential statistics concerning adverse effects gastrointestinal complications, sedation, dry mouth, urinary complications in both groups. Table 4 Adverse effects in the oxybutynin and placebo groups. Discussion The key findings of the present double-blind, randomized, clinical study of the effects of oxybutynin on sweating in patients with major depressive disorder treated with sertraline were that, compared with placebo, oxybutynin decreased subjective sweating over time, few adverse effects were reported, and female patients reported a greater decrease in sweating than male patients, irrespective of treatment allocation.
Acknowledgment The present paper is based on the doctoral thesis completed by Zahra Sherafat. Footnotes Disclosure The authors report no conflicts of interest in this work. References 1. Synopsis of Psychiatry. Spiegel R. An Introduction. How antidepressants work: new perspectives on the pathophysiology of depressive disorder. Br J Psychiatry. Feeling a little less stressed now? We sure hope so. Patients Family and Friends. Medical Professionals. Linked to Breast Cancer?
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