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Medications that cause hot flashes and night sweats

Medications that cause hot flashes and night sweats include antidepressants (SSRIs such as sertraline/Zoloft and fluoxetine/Prozac, and SNRIs such as venlafaxine/Effexor), opioid painkillers, steroids such as prednisone, dementia medicines, and breast cancer therapies like tamoxifen. If sweats began after a new prescription or dose change, review it with your prescriber before assuming perimenopause. Never stop a prescribed medicine on your own.

Antidepressants like sertraline and venlafaxine, tamoxifen, opioids and some diabetes drugs can cause sweating. Common culprits and what to ask your doctor.

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Medications and hot flashes: expectation vs reality

What people often expect

“Antidepressants treat hot flashes, so they can't cause them”

What the evidence shows

Both are true. Low-dose paroxetine and venlafaxine reduce menopausal hot flashes by about 40–65%, yet excessive sweating is a known side effect of SSRIs, venlafaxine and tricyclic antidepressants. The difference is partly dose and partly the person: the same drug can calm hot flashes in one woman and trigger sweating in another.

Why some medications cause hot flashes and night sweats

How medications change sweating

Sweating is controlled by the brain and nerves. Some drugs act centrally, at the hypothalamus or the spinal centers that control temperature; others act on the nerves that switch on sweat glands. Either way, you can flush and sweat without a real fever. A review of drug-induced sweating lists cholinesterase inhibitors for dementia, SSRIs, opioids and tricyclic antidepressants among the drugs that cause excess sweating.

Antidepressants and night sweats

Excessive sweating has been linked with tricyclic antidepressants, SSRIs and venlafaxine. In a reported case, a 59-year-old woman developed sweating mainly on her head and neck months after starting paroxetine, and it cleared gradually over 5 weeks after stopping. Management options include lowering the dose, switching to another antidepressant, or adding a medicine to control sweating. Sweating can start weeks or months after the first dose, so the link is easy to miss.

Steroids and prednisone hot flashes

The NHS lists steroids among the most common causes of night sweats, alongside some antidepressants and painkillers. Prednisone and prednisolone can cause flushing and sweating, often worse at night. Sweating from a short course usually settles when the course ends. If you're on long-term steroids, talk to your doctor rather than stopping, since steroids must be reduced gradually. Keep a note of when the sweats started so your doctor can see whether they match the steroid course.

Breast cancer treatment and hot flashes

Breast cancer endocrine treatments lower estrogen or block its effects, reproducing menopause-like hot flashes. Hot flashes are the most prominent side effect of tamoxifen. In one study, about half of women starting tamoxifen reported substantial hot flashes, which built up over 3 months and then plateaued. Women who had moderate to severe hot flashes in menopause, or had used estrogen before, were most likely to be affected.

Medication sweats vs perimenopause hot flashes

Timing separates medicine from midlife hormones. Perimenopause flashes often track irregular periods and age. Drug-linked sweats usually start weeks or months after a new medicine or dose change, may happen at night even when you feel cool, and can improve when the dose changes under medical supervision. Keeping a simple timeline of symptoms and prescriptions is the fastest way to tell.

How common are medication-induced hot flashes?

About half

of women starting tamoxifen had substantial hot flashes in one study

11.4 a day

average moderate to severe hot flashes in women on breast cancer endocrine therapy entering a 2025 trial

5 weeks

for sweating to clear after stopping paroxetine in one reported case

Most drug side-effect data count sweating as a yes-or-no event, so there's no reliable figure for how many women get hot flashes from a given antidepressant or steroid.

Medications that can cause hot flashes and night sweats

SSRIs and SNRIs
Sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), escitalopram (Lexapro), venlafaxine (Effexor), desvenlafaxine (Pristiq)
Sweating is a recognized side effect, sometimes mainly on the head and neck. Paradoxically, low doses of some of these drugs also treat menopausal hot flashes.
Tricyclic antidepressants
Amitriptyline, nortriptyline
Can cause both excess and reduced sweating, depending on the person.
Opioid painkillers
Codeine, tramadol, morphine
Listed among drugs that cause excess sweating. The NHS includes painkillers among common causes of night sweats.
Steroids
Prednisone, prednisolone
The NHS lists steroids among the most common causes of night sweats. Never stop long-term steroids suddenly.
Breast cancer endocrine therapy
Tamoxifen, anastrozole, letrozole, exemestane
Hot flashes are common and can be severe; they're the most prominent side effect of tamoxifen.
Dementia medicines
Donepezil, rivastigmine (cholinesterase inhibitors)
Can cause excess sweating by acting on the nerves that control sweat glands.
Diabetes medicines
Insulin, sulfonylureas
They don't cause sweating directly, but low blood sugar does, and the NHS lists low blood sugar among common causes of night sweats.

Is it the medication or perimenopause?

In midlife, a new medicine and perimenopause often arrive at the same time. Timing is the best way to tell them apart.

Perimenopause
Check →
Flashes with changing periods, in your 40s or 50s, unrelated to a new medicine.
Test: Over 45, identified from symptoms
Low blood sugar
Sweats on diabetes medicine or after skipped meals, with shakiness.
Test: Blood sugar check
Infection
Check →
Sweats with a fever, cough, diarrhea or weight loss.
Test: Doctor's assessment
Anxiety
Check →
Sweating with worry, a racing heart and tension, whatever you take.
Test: Doctor's assessment

What to do if a medication causes night sweats

Review the medication with your doctor
If this is the cause
Bring a timeline of when sweats started relative to each prescription or dose change. Your doctor or pharmacist may lower the dose, switch to an alternative, or plan a supervised taper if stopping is safe. The published recommendation for antidepressant sweating is to consider dose reduction first, then a switch. Don't stop prescribed medicines without advice, since some cause withdrawal effects.
Add-on treatment for medication sweating
Limited evidence
When the medicine must continue, doctors sometimes add a second drug to reduce sweating. Reviews mention alpha blockers for night sweats on serotonin reuptake inhibitors, and benztropine or cyproheptadine for antidepressant sweating, with evidence mostly from case reports rather than large trials. Because the evidence is thin, a dose change or switch is usually tried first.
Elinzanetant for hot flashes from breast cancer therapy
Strong evidence
In a 2025 randomized trial in women on breast cancer endocrine therapy, elinzanetant reduced daily moderate to severe hot flashes by 6.5 at week 4, against 3.0 on placebo, and the benefit held at week 12. The most common side effects were headache, fatigue and sleepiness. Oncology teams can discuss non-hormonal options when flashes threaten sleep or treatment adherence.
Cooling and comfort measures
First step
While the medicine is being reviewed, a cool bedroom, light layers, a fan and cold drinks make sweats easier to live with. Cutting alcohol and spicy food in the evening removes extra triggers. These don't fix the cause but help you sleep in the meantime.

When to talk to your doctor about medication sweats

Sweats started after a new medicine or dose change
Talk to your doctor or pharmacist. Don't stop it on your own.
Hot flashes on breast cancer treatment
Tell your oncology team. Effective non-hormonal options exist, and untreated flashes are a common reason women stop their treatment early.
Sweats with a fever, cough or weight loss
See a doctor. These point to causes other than medicines or menopause.

Medications that cause night sweats: questions women ask

Which antidepressants cause night sweats?

SSRIs such as sertraline (Zoloft), paroxetine and fluoxetine (Prozac), the SNRI venlafaxine (Effexor), and tricyclic antidepressants can all cause sweating. It doesn't happen to everyone, and a lower dose or a switch often helps. Sweating can start months after the first dose, so mention it even if you have been on the medicine for a while.

Does Zoloft cause night sweats?

It can. Sertraline (Zoloft) is an SSRI, and excessive sweating is a recognized SSRI side effect. A lower dose or a switch often helps; talk to your prescriber before changing anything. If the sweats are mild and the medicine is working well for your mood, simple cooling measures may be enough while you decide.

Does Lexapro cause night sweats?

It can. Escitalopram (Lexapro) is an SSRI, and sweating is a recognized side effect of the class. Interestingly, escitalopram is also one of the antidepressants that can reduce menopausal hot flashes, so the effect varies between women.

Can prednisone cause hot flashes and night sweats?

Yes. Steroids such as prednisone are among the most common medicine causes of night sweats. Sweats from a short course usually stop when it ends. Don't stop long-term steroids on your own. Long courses need to be tapered under medical supervision.

How long do sweats last after stopping a medicine?

In one reported case, sweating from paroxetine resolved gradually over 5 weeks after stopping. Timelines vary with the drug and how long you took it. If sweats continue well after stopping, other causes, including perimenopause, need a look.

Can you treat hot flashes caused by tamoxifen?

Yes. Non-hormonal options exist; a 2025 trial of elinzanetant roughly halved hot flash frequency beyond placebo in women on endocrine therapy. Some antidepressants are also used, but check with your oncologist, since some interact with tamoxifen.

What drugs cause night sweats?

The most common are antidepressants, steroids and painkillers, according to the NHS. Opioids, dementia medicines, breast cancer hormone therapies and diabetes medicines that cause low blood sugar are other culprits. If sweats started with a new medicine, ask your doctor or pharmacist.

Does Effexor cause night sweats?

It can. Venlafaxine (Effexor) is linked with excessive sweating, even though low doses are also used to treat menopausal hot flashes. If sweating is a problem, a dose change or switch may help. Do not stop venlafaxine suddenly, as that can cause withdrawal symptoms.

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