Toxic epidermal necrolysis (TEN) is a distinct clinical entity within a spectrum of adverse cutaneous drug reactions. It is characterized by >30% of the body surface area of skin detachment with an average reported mortality of 25-35%. Drug induced TEN is associated with various antibiotics, anticonvulsants and other drugs. While adverse cutaneous drug reactions are common with antidepressants, the majority eruptions are benign and easily treated. TEN is rarely reported in association with selective serotonin reuptake inhibitors (SSRI's). We describe TEN in a 34-year-old patient from Mozambique associated with the addition of fluoxetine for a major depressive episode with psychotic features.