“MR. K,” a 64-year-old gentleman was admitted with complains of recent memory deficits, apathy, and impairment in activities of daily living over the last 4 months. On evaluation, he was found to have a history of depressive symptoms such as sad mood, lack of interest, anhedonia, easy fatigability, poor sleep quality, lack of confidence, death wishes, and depressive cognitions in relation to stressors before the onset of these problems. He had no history of vascular risk factors. There was no past history suggestive of head injury or seizures. He had a body mass index (BMI) of 20.1. Investigations on the day of admission were as follows: serum sodium: 138 meq/liter; serum potassium: 5.3 meq/liter; random blood glucose: 83 mg/dl; blood urea: 21 mg/dl; serum creatinine: 0.80 mg/dl; and normal liver-function values. Thyroid-function test and vitamin b12 assay were within normal limits. ECG did not reveal any abnormality. Computed tomography of the brain was normal except for mild age-related cortical atrophy. A comprehensive neurology evaluation did not suggest any evidence of abnormality or focal signs. A diagnosis of depressive pseudo dementia was made and the patient was started on tablet sertraline 25 mg per day for 2 days and subsequently 50 mg per day. The patient was noticed to be taking adequate fluids and food during the inpatient stay. On the fourth day of treatment initiation, he developed generalized tonic clonic seizure. Blood was sent for examination of biochemical parameters. The biochemistry report showed serum sodium level of 115 meq/liter. He was treated immediately with a loading dose of phenytoin for the management of generalized convulsions, hydric restriction, and sodium chloride infusion. Given the absence of any other risk factors to precipitate hyponatremia in this patient, a possibility of sertraline-induced hyponatremia was considered. The suspected offending drug was withheld, and the serum sodium values were serially monitored. The patient did not develop any further convulsions and became clinically better in 2 days. The sodium value reached normal level of 134 meq/liter on the fourth day.