Match each patient's clinical presentation with the most appropriate initial pharmacological intervention.
- A 78-year-old woman with a 6-week history of depressed mood, profound insomnia, and an unintentional 4-kg (8.8-lb) weight loss.Mirtazapine
- A 55-year-old man with a 2-month history of anhedonia, low mood, and severe bilateral burning foot pain due to long-standing diabetes mellitus.Duloxetine
- A 34-year-old woman with a 3-month history of depressed mood, profound fatigue, and weight gain, who explicitly requests a treatment that will not cause sexual dysfunction.Bupropion
- A 45-year-old man with a 4-week history of severe depression, psychomotor retardation, and a fixed belief that his internal organs are rotting.Sertraline and olanzapine
Answer
The 78-year-old woman with insomnia/weight loss matches with mirtazapine. The 55-year-old man with diabetic neuropathy matches with duloxetine. The 34-year-old woman avoiding sexual dysfunction matches with bupropion. The 45-year-old man with somatic delusions matches with sertraline and olanzapine.
The correct matches align the unique pharmacologic profiles (including mechanism of action and common adverse effects) of specific medications with each patient's clinical needs. Mirtazapine provides targeted relief for insomnia and anorexia. Duloxetine addresses both mood and neuropathic pain. Bupropion avoids sexual side effects while mitigating fatigue. A combination of an antidepressant and antipsychotic is mandated for psychotic depression.
Step-by-Step Solution
Key Concept
Tailoring pharmacotherapy for major depressive disorder based on patient-specific symptom clusters, medical comorbidities, and desired side-effect profiles.
Estimated Time:1m 30s