Psych- SSRI
harry206 - 05-18-09 07:52

A 54-year-old woman comes to your office. She has been your patient for several years, and you usually
see her for her annual physical. You have long suspected depression because of her vague somatic
complaints, but she has previously denied being in a depressed mood or anhedonia. At this visit she
admits to feeling depressed "more often than not" and she is no longer interested in her gardening club
or playing with her grandchildren. She tearfully reports increasing difficulty in falling asleep and
exhaustion during the day for the last several weeks. She has a decreased appetite and has lost 25
pounds in the last 3 months. She denies suicidality, homicidality, or psychotic symptoms. She denies
drug and alcohol use. She is a depressed-appearing woman with very poor eye contact and moderate
psychomotor retardation. She scores a 29/30 on the Mental Status Exam. Her physical examination is
normal. You review the chart, and recall this patient has no allergies and her only medication is estrogen
replacement status post a total hysterectomy 10 years ago. You order a TSH and decide to start an
antidepressant. You prescribe a selective serotonin reuptake inhibitor. You should advise her that