Type of article: Case Report Title: Antidepressant induced excessive sweating (ADIES) or hyperhidrosis

Background: Antidepressant-induced excessive sweating (ADIES) is a common antidepressant-related side effect, and its prevalence is estimated to range from 4 - 22%. Adverse effects are a common reason for nonadherence and discontinuation of antidepressant medication, and alleviating these side effects may improve adherence and promote positive outcomes Case description: We report 2 cases who were on antidepressants (SSRI) for anxiety disorder and major depressive disorder. After using the drug both patients developed excessive sweating over a period of time, which was found to be independent of their pre-existing condition. Stopping the drug helped in relieving sweating but when the drug was given again sweating recurred. Later on they were given with benztropine and glycopyrrolate which helped their symptoms successfully. Discussion: Adrenergic actions of antidepressants are implicated in causing ADIES. Agents that have been reported successful in controlling the sweating include benztropine and glycopyrrolate. Conclusion: We recommend a patient-specific approach for the management of ADIES. First, consider dose reduction or a trial off antidepressant medication. If patients in whom this is inappropriate or ineffective, substitution of other antidepressant may be considered. If episodes of excessive sweating persist, consider treatment with benztropine or glycopyrrolate or terazosin in the absence of contraindications.