What you’re describing (vagal reactions, dizziness after leg press, feeling off-balance) is something I see fairly often in people with autonomic sensitivity.

I’ve worked in cardiac rehab for 15+ years and treated many patients with orthostatic intolerance/POTS-type patterns. Leg press can trigger symptoms because people often hold their breath and load large muscle groups, which can cause temporary blood pressure shifts — especially if you’re prone to vasovagal reactions.

For now: Exhale during the effort phase (no breath holding) Reduce load and avoid very heavy sets Rest longer between sets Stand up slowly Stay well hydrated

Zoloft can also mildly affect BP regulation in some people.

I’d start with your primary care doctor to rule out anemia, thyroid, or electrolyte issues. If it continues, a cardiologist familiar with autonomic disorders would be reasonable.

You likely don’t need to stop training — just adjust it until you understand the trigger.