uk-dgm MCQ (SBA): First-Line Antidepressant in Older People

A 75-year-old woman presents to her GP with a 4-week history of low mood, poor appetite, weight loss of 3 kg, early morning wakening, and loss of interest in her grandchildren. She has hypertension and type 2 diabetes. She scores 18 on the PHQ-9 (moderately severe depression). She has no suicidal ideation. She currently takes Ramipril 5 mg and Metformin 500 mg BD. What is the MOST appropriate first-line pharmacological treatment?