Correspondence: Saeed Afzali, Poisoning Ward, Farshchian Hospital, Hamadan, Iran. Tel: +98 811 8285012. Fax: + 98 811 8269808. E-mail: afzali691@ yahoo.com (Received 6 September 2011; accepted 16 April 2012) ORIGINAL ARTICLE Effect of terazosin on sweating in patients with major depressive disorder receiving sertraline: A randomized controlled trial ALI GHALEIHA 1 , KADIJEH MOGHADASIAN SHAHIDI 2 , SAEED AFZALI 3 & NASRIN MATINNIA 4 1 Department of Psychiatry, Behavioral Disorders & Substance Abuse Center of Hamadan University of Medical Sciences, Hamadan, Iran, 2 Department of Psychiatrist, Hamadan University of Medical Sciences, Hamadan, Iran, 3 Department of Clinical Toxicology, Behavioral Disorders & Substance Abuse Center of Hamadan University of Medical Sciences, Hamadan, Iran, and 4 Basic Science Department, Islamic Azad University Hamadan, Iran Abstract Objective. By considering the role of adrenergic nervous system in sweat secretion, we postulated that terazosin may be able to improve sweating after taking sertraline, a selective serotonin reuptake inhibitor (SSRI) drug. This study was designed to evaluate the effect of terazosin on sertraline -related sweating. Methods. All patients diagnosed with major depressive disorder based on the DSM-IV criteria who were taking sertraline and suffered from excessive sweating were enrolled in the study and randomly allocated into two groups of receiving terazosin (1 mg) or placebo. Sweating severity was classified using Hyperhidrosis Disease Severity Scale. The patients were evaluated regarding the severity of sweating before beginning of the study and 14 days after taking either terazosin or placebo. Results. Baseline characteristics including age, sex propor- tion and weight were not significantly different between the two groups ( P  0.05). At the beginning of the study, 33 (48.5%) and 31 (47%) patients in the terazosin and placebo groups, respectively, suffered from the highest grade of sweat- ing. Fourteen days after treatment with terazosin severity of sweating reduced to the lowest grade in 46 (68%) and two (6%) cases in the terazosin and placebo groups, respectively ( P  0.001). Conclusions. Our findings revealed that terazosin may be effective in decreasing sweating severity in patients using sertraline. Key Words: Terazosin, sertraline, sweating, major depression Introduction Major depressive disorder (MDD) is an important public health problem and is considered to be the leading cause of suicide worldwide [1]. Selective serotonin reuptake inhibitors (SSRIs) are generally considered as the first choice for treatment of MDD and are used widely throughout developed countries [1,2]. Although side effects of SSRIs occur less fre- quently than those of tricyclic antidepressants, some side effects including nausea, diarrhea, headache, tremor, nervousness, insomnia, and sexual dysfunc- tion, as well as excessive sweating, may develop in individuals taking SSRIs [1,3]. Sweating is a common side effect of treatment with SSRIs and occurs in 7–19% of patients [4] and specifically in 8% of patients taking sertraline [5]. The incidence of SSRI-related sweating may be even higher with some SSRIs, as in one study excessive sweating was reported to be as high as 33% in patients receiving paroxetine [6]. Increased sweating may negatively affect quality of life of patients, interfere with daily activities, and result in non-compliance with treatment [7,8]. Considering the role of noradrenergic (both peripherally and centrally) and cholinergic nervous systems in sweat secretion [3], medical therapies including terazosin, an α-adrenergic blocker [9], as well as anticholinergic agents such as benztropine [10] and oxybutynin [8,11], have been suggested to be effective in the control of excessive sweating. However, to the best of our knowledge, there has been no randomized controlled trial to assess International Journal of Psychiatry in Clinical Practice, 2013; 17: 44–47 ISSN 1365-1501 print/ISSN 1471-1788 online © 2013 Informa Healthcare DOI: 10.3109/13651501.2012.687449