Question

A 42-year-old woman presents with low mood, anhedonia and fatigue for 3 months. She has difficulty sleeping and concentrating, but denies suicidal ideation. Function is moderately impaired. There is no history of mania. What is the most appropriate first-line management according to NICE guidance?

Accepted Answer

Offer psychological therapy such as cognitive behavioural therapy as first-line, considering antidepressants based on shared decision-making

Answer

Start a tricyclic antidepressant immediately without further assessment

Answer

Recommend St John’s Wort from the pharmacist

Answer

Admit to psychiatric hospital urgently

Answer

Start long-term benzodiazepines for sleep

Practice question

A 42-year-old woman presents with low mood, anhedonia and fatigue for 3 months. She has difficulty sleeping and concentrating, but denies suicidal ideation. Function is moderately impaired. There is no history of mania. What is the most appropriate first-line management according to NICE guidance?