Peripheral edema associated with the combination of mirtazapine and escitalopram

Escitalopram is a broadly used Food and Drug Administration-approved Selective Serotonin Reuptake Inhibitor (SSRI) for major depressive disorder and generalised anxiety disorder. Peripheral edema associated with this drug is documented in limited literature, with only seven studies identified, two originating from India.^{1 , 2} The primary proposed etiology for this side effect is increased vascular permeability, potentially due to an idiosyncratic reaction linked to the drug's serotonergic effects. Mechanisms thought to contribute include serotonergic 5HT2A antagonism and α1 antagonism. However, a definitive cause or mechanism remains unestablished, highlighting the need for further investigation into this side effect. This report discusses a rare case of peripheral edema in a young female patient, emphasizing the importance of recognizing rare adverse reactions in diverse populations. Enhanced awareness and continued research could lead to better understanding and management of this uncommon yet notable side effect of escitalopram.