Drug-induced diaphoresis is profuse, excessive, or increased sweating due to effects of medication or substance use. Medication groups that are known to cause sweating are cholinergic, hypoglycemic, antidepressant, antipyretic, and hormonal agents. Less commonly implicated medications include beta blockers, calcium channel blockers, protease inhibitors, sympathomimetics, and migraine medications. Substances such as opioids, alcohol, and cocaine, along with substance withdrawal syndromes, are known to cause diaphoresis.

The pathophysiology of drug-induced diaphoresis depends on the mechanism of action. Drugs that augment cholinergic transmission commonly cause hyperhidrosis by stimulating peripheral muscarinic receptors. This class of drugs include cholinesterase inhibitors and accidental poisoning caused by the organophosphate pesticides.

Antidepressants are a common cause of medication-induced hyperhidrosis. Although antidepressants cause generalized hyperhidrosis, patients may complain of night sweats.

Medication-induced hypoglycemia is another important cause of sweating. Sweating is a prominent clinical feature of hypoglycemia, especially in patients who are taking hypoglycemic agents such as insulin or sulfonylureas.

In addition to flushing, hormonal agents can also cause excessive sweating and medication-induced hot flashes. This includes aromatase inhibitors, antiestrogen medications and androgen receptor blockers.

Related topic: Drug-induced flushing reaction