The correspondence deals with the safety of antidepressants in the perioperative period, specifically their effect on the QT interval and sodium level in the blood.[1][2] The authors caution that the results of the meta-analysis by Toby Pillinger and colleagues, based on low-risk acute studies, may be misleading for perioperative care.[1] In the perioperative setting, the risks associated with QT prolongation and hyponatremia (low sodium) are amplified.[1] Tricyclic and heterocyclic antidepressants increase the risk of cardiac complications and can cause severe Torsades de Pointes type arrhythmias, especially with a longer QT interval above 500 msec.[1][2] During treatment with antidepressants, it is recommended to regularly monitor the ECG in people over 50 years of age and to check potassium and magnesium levels.[2] Treatment should be started slowly with a gradual increase in doses and without exceeding the recommended doses.[2]