A 38-year-old man presents with low mood, anhedonia, poor sleep and impaired concentration for 2 months. He has no history of mania or psychosis and n...

Question

A 38-year-old man presents with low mood, anhedonia, poor sleep and impaired concentration for 2 months. He has no history of mania or psychosis and no substance misuse. There is no active suicidal ideation. What is the most appropriate initial management?

Accepted Answer

Initiate a selective serotonin reuptake inhibitor (SSRI) and offer psychological therapy

Answer

Start a benzodiazepine as monotherapy

Answer

Start a tricyclic antidepressant as first-line

Answer

Recommend herbal preparations only

Answer

Refer immediately for electroconvulsive therapy (ECT)

ca-mccqe1 MCQ (SBA): Major depressive disorder

A 38-year-old man presents with low mood, anhedonia, poor sleep and impaired concentration for 2 months. He has no history of mania or psychosis and no substance misuse. There is no active suicidal ideation. What is the most appropriate initial management?