Orthostatic hypotension induced by sertraline withdrawal

Sertraline is a member of the newest class of antidepressants, the selective serotonin reuptake inhibitors. Due to its inherent selectivity and its lack of action with norepinephrine, dopamine, monoamine oxidase, and cholinergic receptors, this drug is unlikely to have any cardiovascular activity. A patient receiving sertraline for depression developed dizziness and orthostatic hypotension on repeated attempts to discontinue the drug. All other organic factors were ruled out. The hypotension was proved to be secondary to sertraline by repeated rechallenges. After a variety of attempted treatments, the agent was discontinued successfully through an extended titration period. This report should guide clinicians in treating patients with a similar problem.