Mr. A is a 55 year old veteran with no past psychiatric history who came to our emergency room in March 2011, complaining of feeling depressed and suicidal. On evaluation he reported depressed mood, anhedonia, poor sleep, hopelessness, poor energy level and poor concentration. He also reported having thoughts that life is not worth living but denied any plan to end his life. His recent stressors include losing his job, family and being homeless. He was admitted to inpatient psychiatric unit and was started on citalopram 20 mg PO everyday for depression. He was also restarted on his home medications which included benazapril, nifedipine, omeprazole and warfarin. He tolerated citalopram well for first five days but on the sixth day, he reported having vivid scary dreams in which he sees himself committing suicide by jumping in front of a train. He described these dreams as memorable and intense. He denies having any history of nightmares in the past. He reported having similar nightmare in which he jumps in front of a train for next two days. He woke up from sleep every time frightened and anxious. He then requested to stop citalopram and be given another antidepressant. Citalopram was stopped and patient was started on wellbutrin. The nightmares disappeared a day after stopping citalopram.