As the global temperatures continue to rise and extreme heatwaves become the new normal, the attention turns to a unexpected but critical health factor: how your prescription medications might be making the summer heat even more intolerable. While everyone knows to drink plenty of water and steer clear of the outdoors during the hottest part of the day, few recognize that prescriptions might be combating their body's cooling mechanisms.

For millions, dealing with the heat is more than a comfort issue—it's a health emergency, particularly for those on certain prescription medications. While dehydration, shade, and sunscreen are important, a lesser-known risk is from the medicine cabinet. Many medications regularly prescribed to millions of Americans can disrupt the body's natural cooling system, making it more difficult to cool down and heighten the risk of heat illness

Millions of Americans, especially those experiencing scorching heat domes in the eastern U.S., are more susceptible to heat illnesses. For those on medications that disrupt thermoregulation, the risks are even greater.

How the Body Regulates Heat?

The human body depends on a number of sensitive mechanisms to keep its internal temperature within a safe range. Sweating, blood flow to the skin, and sensitive fluid balance all dissipate heat. But certain drugs interfere with these mechanisms by changing the production of sweat, the way the blood circulates, or thirst and fluid retention. The consequence: a higher risk of overheating, dehydration, and potentially life-threatening heatstroke.

How Medication Undermines Body's Ability to Withstand Heat?

Below are five popular types of medications that disrupt your heat tolerance, and how you can get around them.

1. Antidepressants

Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), are the most widely used medicines globally. Antidepressants act by modulating neurotransmitter levels in the brain, primarily serotonin and noradrenaline. They do affect other systems that regulate body temperature as well.

TCAs, for instance, can block acetylcholine, a neurotransmitter essential to sweating. This can result in diminished sweat, and the body is less able to cool itself on warm days. Ironically, both SSRIs and TCAs have the opposite effect on some users as well—up to 14% report this side effect—and stimulate sweat glands through excessive noradrenaline. This excessive sweating can contribute to dehydration if fluids aren't replenished.

In addition, SSRIs can interfere with the hypothalamus, the thermostat of the brain, and cause the signal to initiate sweating to be interrupted. Any disruption in sweating—either too much or too little—will make the body less able to deal with heat, increasing the danger of heat exhaustion or heatstroke.

2. Antipsychotics

Antipsychotic medication, prescribed to patients with schizophrenia and bipolar disorder, can also increase the danger of summer heat. They block dopamine, which has a side effect of impacting serotonin and interfering with the hypothalamus's function of detecting and responding to changes in temperature.

Individuals on antipsychotics can be as non-heated and non-thirsty as possible when their bodies are under pressure. This can cause plummeting blood pressure and impaired cardiac function. The body adapts by vasoconstricting and holding onto heat, further diminishing the sweat and cooling capacity. Most antipsychotics are also anticholinergic, inhibiting acetylcholine and making sweating even more difficult.

3. Heart Drugs

Cardiovascular medications are another important category that can disrupt heat tolerance. Beta blockers, used in heart failure and arrhythmias, slow the heartbeat and decrease the strength of heart contractions. Although effective for heart disease, these actions can restrict blood flow to the skin, lessening the body's ability to dissipate heat.

Diuretics, which are often prescribed to manage high blood pressure and heart failure, boost urine production and lead to dehydration and electrolyte imbalances—both of which make it more difficult to sweat effectively. Other medications for high blood pressure, including ramipril and losartan, can suppress the body's natural thirst drive by interfering with the body's fluid balance mechanism, increasing the risk for dehydration in hot weather.

4. Stimulants

Stimulant drugs like amphetamines used for ADHD can raise body temperature, enhance metabolism, and distort patterns of sweat. These medications target dopamine and noradrenaline, which can make cooling down more difficult, particularly after physical exertion or in hot weather. Stimulants can also suppress feelings of fatigue, leading people to overwork without perceiving the risk.

Interestingly, some studies indicate that individuals with ADHD who use stimulants can have a reduced risk for heat-related illness, perhaps as a function of reduced body weight or improved hydration practices. More research is necessary to verify this effect.

5. Insulin and Diabetes Medications

For individuals with diabetes, control of blood sugar during heat is tough. High temperatures dilate blood vessels, enhancing blood flow and accelerating the absorption of insulin. This may result in hypoglycemia (low blood sugar), with signs such as dizziness, perspiration, irritability, and even loss of consciousness or seizures.

Heat can also destroy insulin, reducing its effectiveness or rendering it dangerous. Insulin must be refrigerated until the time of use, and any alteration in color or cloudiness means it must be thrown away. Other diabetes medications, including sulfonylureas, may also predispose patients to sun sensitivity and dehydration.

How Are Medications and Sun Sensitivity Linked?

Aside from thermoregulation, various drugs heighten sensitivity to the sun. Antibiotics, antihistamines, oral contraceptives, and diabetes medications such as insulin may all augment the risk of heat reaction and sunburn. Always look for warnings regarding exposure to the sun on drug labels and take special precautions such as sunscreen and shade.

Outside of these five major categories, a number of other medications can make it more difficult to deal with the heat. Antibiotics, antihistamines, antifungals, and certain cholesterol-lowering statins all can raise sun sensitivity, increasing risk of sunburn or rash. Oral contraceptives and hormone therapies might also be expected to do the same.

Tip to Cope and Stay Cool This Summer

If you are on one of these medications, you do not have to endure summer. Begin by talking to your healthcare professional to learn your individual risk factors. Do not stop any prescribed drug without discussing with a doctor. Some major coping mechanisms include:

• Stay well hydrated unless otherwise instructed by your physician.
• Keep medications such as insulin and inhalers in a proper condition to continue being effective.
• Wear loose, light garments and broad-spectrum sunscreens.
• Avoid leaving your home during the 10 a.m. to 4 p.m. peak heat times.
• Watch for dizziness, confusion, nausea, or profuse sweating.

Does Heat Affect Mental Health?

Heat also affects mental health, whereas winter seasonal affective disorder (SAD) is more well-known, summer SAD may result from inadequate sleep and protracted heat exposure, aggravating depression and anxiety symptoms. Heat doesn't only impact the body—some individuals have summer-pattern seasonal affective disorder (SAD), with deteriorating depression or anxiety during extended, hot days. Inadequate sleep resulting from heat can also heighten these symptoms. Hydration, cooling down, and stress management practices such as deep breathing or meditation can assist with maintaining mental health during heat waves.

The Anxiety & Depression Association of America suggests staying hydrated, practicing mindfulness techniques for stress management, and getting proper rest. For individuals who are experiencing mental fatigue in the summer months, contacting a mental health professional is highly recommended.

As we endure increasingly hotter, longer summers, it is more important than ever to know how drugs interact with heat. From antidepressants to insulin, every drug has special risks related to thermoregulation, dehydration, and sun sensitivity.

For people on antidepressants, antipsychotics, cardiac medications, stimulants, or insulin, summer poses special challenges—but also the potential for proactive self-protection, see your physician or health care provider for further assistance.

Disclaimer: This article is for informational purposes only and does not substitute professional medical advice. Always consult your doctor before making changes to your medication or health routine.

‘Inner Child’ is Health and Me's new mental health series where we deep dive into lesser-known aspects of child psychology and how it shapes you as you grow up. Often unheard, mistaken, and misunderstood, in this series we talk about the children’s perspective and their mental health, something different than you might have read in your parenting books. After all, parenting is not just about teaching but also unlearning.

Sometime 90 years ago, a psychologist proposed that birth order could have an impact on what kind of person the child becomes once they grow up. It is true, childhood, of course, shapes your personality as you grow up. But what does it mean to be the last one in the birth order?

It was the COVID-19 pandemic, when I started to jot down how I felt when suddenly I was home with my entire family under the same roof. Thanks to lockdown restrictions, I was again reminded that I am the youngest in the family. This is when I started writing a journal that I thought I would publish into a book once I finished it. I called it "To Be The Second Born". I jotted down my experience of being the youngest in the house, especially when everyone around me, including both my parents, are the oldest in their family.

Contrary to the belief that we are spoiled, I felt that we are often unheard and ignored, because we are always "too young" to be taken seriously. As a result, we revolt and are tagged as defiant. Five years down the line, my boss shared an Instagram reel that described how I felt. The reel went on to talk about how no one sees the struggle of a younger sibling. Or how everyone thinks they always got it easy. When, in reality, it is often because we are so used to being misunderstood that we shut ourselves down, not telling anyone about what is going on. Instead of fighting the 'defiant' tag, we start to live with it. We take responsibility, but never talk about it, because we know we will not be heard.

Watching that reel made me realize that it is not just me, but a lot of younger siblings who feel the same. While the book seems like a distant dream, a piece on it doesn't.

If you, too, feel the same, this one is for you.

ALSO READ: Inner Child: When the Bullied Turns Into A Bully – Psychology Of A Victim’s Defense Turned Attack

Too Young To Matter?

Krishna, 32, who is originally from Bihar, now in Pune, is the youngest of all the siblings. She has three older siblings, and she tells me that she often felt like a "stupid".

This is because her older siblings were very "authoritative". When asked why, she says, "I think culturally, we tend to equate age with wisdom and hence, anyone older than us automatically gets elevated to wiser in comparison."

She tells me that she, too, struggled putting her foot down and was often treated as a pushover. It was not until she turned 25 that she openly started to question whatever she was told. Before that, she used to hide things just to avoid confrontation.

The reaction was not pleasant. "There was a lot of gaslighting," she tells. However, she stayed firm and made it clear that she needs to be heard too, and should not be controlled.

To get a better understanding of why this happens, I spoke to Dr Rahul Chandok, who is a senior consultant and head of psychiatry at Artemis Lite, NFC, Delhi. Chandok explains, "When older siblings are in charge of younger ones and always telling them what to do or correcting them, the younger child may start to doubt themselves or feel bad about themselves. Being told what to do all the time can make it harder for them to think for themselves or trust their own decisions. As time goes on, they may start to hide their thoughts or not take the lead because they are afraid of being judged or criticized."

This dynamic can also make younger siblings more anxious or angry. Kati Morton, who is a licensed therapist and a public speaker renowned for her YouTube channel focused on mental health, points out that the youngest children might develop a heightened need for external validation to feel secure about their decisions and actions, potentially leading to anxiety about making mistakes or disappointing others.

Chandok explains that this is also true because of repeated invalidation. The reason why younger siblings may often feel like a pushover is because they have been constantly told that their opinions are wrong, "just because they are younger".

"Over time, such behaviors can hurt self-esteem, lower self-confidence, and make it hard to speak up for themselves in relationships or at work," explains Chandok.

But, Younger Siblings Are Perceived As Defiant And Indifferent

This is because people often get the wrong idea, explains Chandok. "If a child is always told what to do and never asked what they think, pushing back may be the only way they feel in control. If they don't follow directions, break rules, or act like they don't care, they might be trying to say, 'I want to be heard'," he explains.

However, not always are the relationships between a younger and older sibling as stringent. For instance, Ayush Upadhayay, 26, who has a three-year age gap with his older sibling, shares that while he has felt unheard, it has not always been a constant feeling. He tries to explain this and says, "They have responsibilities and feel that we are not yet ready for it."

When asked if that made him feel neglected or incapable, he said that earlier it used to make him feel that, however, now, he has confronted his older sibling. "Initially, she defended her behavior, later, she understood why I felt that way."

In Such Scenarios, What Can Families Do?

Families need to make room for everyone to have a say, no matter how old they are. Chandok also explains that families must encourage kids to talk to each other openly. This conversation must allow younger kids to be heard without being interrupted or judged. "Older siblings can make a big difference by asking for their opinions, respecting their choices, and not being bossy," says Chandok.

From a young age, parents too should encourage younger kids to make decisions, make choices, and not just praise them for following rules, but also being unique, thinking differently, even when their opinions may not match with the rest.

Heart disease remains the leading cause of death worldwide, claiming millions of lives each year. Among its most devastating manifestations is cardiac arrest—a sudden, unexpected stoppage of heart function that, if not treated immediately, is almost always fatal. Recent research has illuminated a crucial, often overlooked fact: the warning signs of cardiac arrest can differ between men and women. Recognizing these differences is not just a matter of academic interest; it can mean the difference between life and death.

Cardiac arrest is often sudden, silent, and deadly — claiming more lives globally than most people realize. But a growing body of research shows that its early warning signs may not be the same for everyone. Specifically, men and women often experience different symptoms before cardiac arrest occurs — and recognizing these differences may mean the difference between life and death.

Sometimes called sudden cardiac arrest, occurs when the heart abruptly stops beating. This cessation halts blood flow to the brain and other vital organs, causing a person to lose consciousness within seconds. Without rapid intervention, such as cardiopulmonary resuscitation (CPR) or use of an automated external defibrillator (AED), death can occur within minutes.

Unlike a heart attack—which is caused by a blockage in the arteries supplying the heart—cardiac arrest is primarily an electrical problem. The heart’s rhythm becomes dangerously abnormal, most commonly due to ventricular fibrillation, causing it to quiver instead of pumping blood effectively.

A recent study published in The Lancet Digital Health has revealed groundbreaking findings that could reshape how we understand and respond to cardiac arrest. Researchers have now confirmed that while chest pain is the most prominent pre-symptom in men, women often experience shortness of breath in the hours leading up to a cardiac arrest episode. The data comes from community-based studies including the PRESTO study in California and the SUDS study in Oregon, which collectively examined how sex-specific symptoms could be harnessed to improve early detection and survival.

According to the study, half of all individuals who experience sudden cardiac arrest have a warning symptom within 24 hours prior to the event. However, these symptoms are not uniform across genders. For women, shortness of breath emerged as the most prominent warning sign, while men most commonly reported chest pain. Other symptoms, such as palpitations, flu-like sensations, and even seizures, were also noted in a smaller subset of patients.

Shortness of Breath vs Chest Pain

In the recent study, researchers found that over 50% of individuals who suffered cardiac arrest had at least one warning symptom within 24 hours. Men most commonly reported chest pain, while women more frequently experienced shortness of breath. A smaller percentage of both groups experienced palpitations, flu-like symptoms, or seizures.

“This is the first community-based study to evaluate sex-specific warning symptoms using real-time emergency medical service (EMS) documentation,” said Eduardo Marbán, Executive Director at the Smidt Heart Institute.

Dr. Sumeet Chugh, the study’s lead investigator, emphasized the impact: “Harnessing these symptoms could guide who needs immediate emergency response. That insight could change survival rates.”

What Exactly Is Cardiac Arrest?

Cardiac arrest, sometimes confused with a heart attack, occurs when the heart stops beating abruptly due to an electrical malfunction. This sudden stoppage halts blood flow to the brain and other vital organs, often causing loss of consciousness within seconds. If not treated immediately — typically through CPR or defibrillation — death can occur within minutes.

It’s different from a heart attack, which is caused by a blockage in the coronary arteries. However, heart attacks can trigger cardiac arrest by disrupting the heart’s electrical system.

Cardiac Arrest vs. Heart Attack

The terms “heart attack” and “cardiac arrest” are often used interchangeably, but they refer to distinct medical emergencies. A heart attack is caused by a blockage that prevents blood from reaching a part of the heart muscle, leading to tissue damage. Cardiac arrest, on the other hand, is an electrical malfunction that causes the heart to stop beating altogether.

While a heart attack can increase the risk of cardiac arrest—by disrupting the heart’s electrical system—not all cardiac arrests are preceded by a heart attack. Other causes include arrhythmias, enlarged heart (cardiomyopathy), severe blood loss, valvular heart disease, and electrolyte imbalances.

Why Younger People Are at Increasing Risk?

The rise in sudden cardiac deaths among young adults is particularly concerning. While some cases are linked to undiagnosed heart conditions such as hypertrophic cardiomyopathy or ventricular arrhythmias, others may be triggered by intense exercise, drug use, or even severe viral infections. These factors can cause the heart to beat irregularly or stop altogether, often without warning. Several factors are contributing to the alarming rise in heart disease and sudden cardiac arrests among young adults:

Genetics and lifestyle: While you can’t change your genes, factors like smoking, poor diet, lack of exercise, and unmanaged stress play significant roles in heart health.

Steroid abuse: Especially among gym-goers and bodybuilders, the use of steroids and growth hormones can damage heart muscles and disrupt rhythms.

Undiagnosed conditions: Conditions like hypertrophic cardiomyopathy or dilated cardiomyopathy (often linked to viral infections like COVID-19) may go unnoticed until it's too late.

Post-COVID heart risks: Myocarditis and lung fibrosis can lower oxygen supply and impair heart function, increasing cardiac vulnerability.

Severe stress: Though rare, emotional trauma can induce cardiac events, especially in those with pre-existing conditions.

Recognizing the Symptoms Before It’s Too Late

For women, these symptoms may present more subtly — and are more likely to be mistaken for stress or anxiety. That’s why public health messaging must evolve to include gender-specific information. While some cardiac arrests strike without any warning, many cases are preceded by symptoms that are often misread or dismissed:

• Chest pain or tightness
• Shortness of breath
• Palpitations or irregular heartbeat
• Fainting or dizziness
• Extreme fatigue
• Nausea or stomach pain
• Sudden sweating or lightheadedness

What You Can Do Today to Prevent Cardiac Arrest?

Preventing cardiac arrest begins with understanding your risk factors and taking proactive steps to protect your heart health. Experts recommend the following:

Routine screening: Start annual checks for blood pressure, cholesterol, and blood sugar levels after age 18.

Know your numbers: Aim for total cholesterol <200 mg/dL, LDL <100 mg/dL, fasting glucose <100 mg/dL, and blood pressure <130/80 mmHg.

Get vaccinated and treated for viral infections: Viruses like COVID-19 can lead to myocarditis and long-term heart damage.

Stop smoking and avoid exposure to secondhand smoke.

Maintain physical activity but with caution. People over 40 or with a family history should consult a doctor before starting high-intensity workouts.

As cardiac events among young people rise and symptoms continue to vary across genders, researchers believe integrating biometric data, wearable tech, and AI-powered health tools can offer early detection solutions in the near future.

United States has seen a nearly 90% drop in heart attack deaths since 1970, thanks to decades of medical advancements and aggressive prevention efforts. However, this victory masks a darker trend: a steep rise in deaths from other, more complex forms of heart disease. According to a new study by Stanford University, Americans are now dying in greater numbers from conditions like heart failure, arrhythmias, and high blood pressure-induced heart disease—silent killers that are surging while heart attack deaths decline.

Back in 1970, 91% of all heart-related deaths were caused by ischemic heart disease—conditions primarily linked to blocked arteries and culminating in heart attacks. By 2022, that number had dropped to 53%, with acute heart attack deaths falling from 354 per 100,000 to just 40 per 100,000.

What fueled this change? The answer is medical innovation and public health progress. The 1960s and 1970s brought the first wave of change, as emergency responders learned CPR, hospitals opened specialized cardiac care units, and doctors began using coronary angiography to map blockages in the heart’s arteries. The introduction of balloon angioplasty in 1977 allowed doctors to physically open clogged arteries, saving countless lives.

The following decades saw the arrival of clot-busting drugs, coronary stents, and cholesterol-lowering statins. Aspirin therapy became standard for heart attack patients. By the 2000s, “door-to-balloon” protocols ensured that patients received life-saving treatment within 90 minutes of hospital arrival. Meanwhile, public health campaigns slashed smoking rates from 40% in 1970 to just 14% by 2019, and doctors became more aggressive in controlling blood pressure and cholesterol.

Why Are Deaths Surging from Other Heart Conditions?

This success came with consequences, the Stanford study, published in the Journal of the American Heart Association, analyzed over 37 million heart disease deaths across five decades. While ischemic heart disease deaths plunged, deaths from other cardiovascular causes surged by 81% overall.

Heart Failure

Heart failure deaths have increased by a staggering 146% since 1970. Heart failure occurs when the heart muscle, often weakened by a previous heart attack or years of high blood pressure, can no longer pump blood efficiently. Patients may survive the initial cardiac event, but face years—sometimes decades—of chronic illness, frequent hospitalizations, and a gradual decline in quality of life.

The rise in heart failure is partly a consequence of longer life expectancy. In 1970, the average American lived to 70.9 years; by 2022, that figure had climbed to 77.5. More people are surviving their first heart attack, but the damage to their heart often sets the stage for future problems.

Dangerous Arrhythmias

Perhaps most striking is the 450% increase in deaths from arrhythmias—disorders that cause the heart to beat too fast, too slow, or erratically. Many arrhythmias are survivable with prompt treatment, but some, like ventricular fibrillation, can be instantly fatal if not treated within minutes. As more people live with damaged or weakened hearts, the risk of developing life-threatening rhythm disturbances rises.

Hypertensive Heart Disease

Deaths from hypertensive heart disease—heart problems caused by years of uncontrolled high blood pressure—have jumped 106% since 1970. High blood pressure silently damages the heart’s structure and blood vessels over time, leading to heart failure, arrhythmias, and sudden cardiac death. Today, almost half of American adults have high blood pressure, up from 30% in 1978.

People are living longer and surviving their first heart attack—but this extended lifespan means their weakened hearts face greater long-term stress, eventually leading to chronic conditions that are harder to manage and treat.

Why A New Cardiac Crisis Looming in US?

The decline in heart attacks has ushered in a new era of complex, chronic heart disease—one that reflects the long shadow of survival.

Dr. Sara King, lead author of the Stanford study, explains, “There have been great strides made in helping people survive initial acute cardiac events that were once considered a death sentence. But this evolution also means we’re seeing more patients dying of conditions like heart failure and arrhythmia years later.”

This shift underscores a critical reality: Surviving a heart attack is not the end of the battle. It’s often the beginning of a lifelong struggle with a heart compromised by disease and further burdened by modern lifestyle challenges.

While we’ve outpaced one killer, we’ve inadvertently empowered three others. The study shows a direct correlation between rising chronic diseases and the surge in non-heart-attack cardiac deaths:

• Obesity rates have skyrocketed from 15% in the 1970s to over 40% in 2022.
• Nearly 1 in 2 American adults now has type 2 diabetes or prediabetes.
• High blood pressure, a silent but deadly force, is present in nearly 50% of U.S. adults, up from just 30% in 1978.

These three conditions fuel the development of heart failure and arrhythmias, compounding long-term cardiac risk even in those who never experience a traditional heart attack.

Improved diagnostic tools have also contributed to the numbers. Conditions like heart failure with preserved ejection fraction—where the heart pumps normally but fills inefficiently—and pulmonary hypertension—high blood pressure in the lungs—are now more readily diagnosed.

While early detection is essential, it also reveals just how widespread and complicated these cardiac conditions have become.

How to Protect and Prevent Modern Heart Conditions?

As the nature of heart disease evolves, so too must our approach to prevention. The American Heart Association’s “Life’s Essential 8” offers a blueprint for reducing risk: eat a healthy diet, manage weight, quit smoking, exercise regularly, improve sleep, and control cholesterol, blood pressure, and blood sugar. These steps are more important than ever, not just for preventing heart attacks, but for reducing the risk of the chronic conditions that now claim so many lives.

Eat healthy: Emphasize whole foods, low sodium, and healthy fats.

Be active: Aim for at least 150 minutes of moderate exercise weekly.

Quit smoking: Tobacco remains a top preventable cause of heart disease.

Manage weight: Obesity is a strong predictor of heart failure and diabetes.

Control cholesterol: Statins and lifestyle changes can dramatically reduce plaque buildup.

Reduce blood pressure: Early treatment can prevent hypertensive heart disease.

Lower blood sugar: Address prediabetes before it leads to full-blown disease.

Sleep well: Quality sleep is increasingly recognized as vital for heart health.

Public health experts also stress the need for better management of chronic diseases like diabetes and hypertension, as well as continued investment in heart disease research and innovation.