Iatrogenic Hypotension Induced by the Improper Treatment of Normal Grief

We report the case of a 28-year-old male in rural Madagascar with iatrogenic hypotension induced by improper treatment of a normal grief response. The man lost both of his children in the spring of 2019 during a measles outbreak that infected at minimum 152,000 individuals on the island. After developing symptoms of chest pain, intermittent tachycardia, and widespread pain when he would think of his children in the weeks following their loss, he was prescribed gabapentin, lisinopril, and metoprolol by a general practice nurse. He subsequently developed dizziness, lightheadedness, and fatigue. After visiting Mada Clinics two weeks later, all medications were stopped, and the man's symptoms resolved. This case demonstrates the effects of a lack of available mental health care in Madagascar, a country with sixteen available psychiatrists for a rapidly expanding population of over 26 million people.