This case report presents the first documented instance of vortioxetine-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH) in India. Vortioxetine, a newer antidepressant, was prescribed to an elderly male in his 80s with major depressive disorder, in combination with mirtazapine. Despite initial improvement in mood, he developed hyponatraemia, a rare but serious side effect possibly linked to vortioxetine's serotonergic action. The patient exhibited symptoms such as giddiness and confusion, prompting the discontinuation of vortioxetine and initiation of corrective treatment. His condition improved, with sodium levels returning to normal while he was maintained on mirtazapine alone. This case underscores vortioxetine's potential to induce SIADH, highlighting the need for careful monitoring and the consideration of alternative antidepressants in vulnerable populations.
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